Loma Linda University Medical Center
Loma Linda, CA, USA
Job Summary: The Coder 1 * Risk Adjustment is responsible for clinical documentation review related to Risk Adjustment Data Validation (RADV) timelines, focusing on completeness and accuracy of provider documentation regarding severity of illness and supporting clinical care plans for Hierarchical Condition Category (HCC) diagnoses. The role involves communication with providers to clarify documentation needs, providing education on documentation integrity, and keeping providers updated on CMS, ICD-10-CM, AHA Coding, and health plan guidelines related to risk adjustment. Performs other duties as needed.
Education and Experience:
Bachelor's degree in Health Information Management or related healthcare field preferred; equivalent education and experience may suffice.
At least 2+ years of clinical/medical experience, including 1+ year in Risk Adjustment coding or Clinical Documentation Improvement/Specialist role.
Knowledge and Skills:
Understanding of electronic medical records,...