The Medical Risk Adjustment Coder supports the physician practices and the Care Coordination Department with Coding Improvement activities using various clinical data systems. Responsibilities include collaborating with internal and external clients to streamline and optimize accurate diagnosis code capture, conducting clinical chart and patient billing audits, adhering to coding rules and CMS guidelines, assisting with HEDIS chart reviews, performing analysis and focused chart reviews, facilitating coding and documentation improvement educational materials, and providing support in the Care Coordination Department. The role also involves performing data validation and integrity functions, monitoring quality, cost, and efficiency, and maintaining compliance with Orlando Health policies.
Qualifications include a high school diploma or equivalent, one of the following certifications: Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC), prior experience with Medicare Risk Adjustment, computer literacy with skills in Windows, Microsoft Word, Microsoft PowerPoint, and Microsoft Excel, and excellent written and verbal communication skills.