May 22, 2024

REMOTE Senior Risk Adjustment Coding Consultant, RADV

  • CSI Companies
  • Remote
  • $26.00 - $30.00 hourly
Full Time, Contract (CPC) Certified Professional Coder (CRC) Certified Risk Adjustment Coder (CCS) Certified Coding Specialist

Job Description

CSI Companies is actively hiring for a REMOTE SENIOR Risk Adjustment Medical Coder for a HHS IVA RADV Audit. The coder will be required to work full-time hours ( minimum 35 hours a week).

This position requires a minimum of 3 years Risk Coding on Commercial Charts. We strongly desire coders with ACA HHS IVA RADV experience.

Check out what other coders are sharing about their experience working at CSI-  Indeed Reviews

The What You Want to Know!

  • 100% REMOTE - Work from home
  • Flexible working schedule
  • PAY PER HOUR model
  • Paid training
  • Long term contract position- Benefits Offered!
  • Required Certification: Active certified coder certification through AHIMA or AAPC required: CRC, CPC, CCS-P, CCS (Certified Risk Adjustment Coder, Certified Professional Coder, Certified Coding Specialist- Physician Based)
  • Pay: $26-30/hr based on experience

The What Will You Be Doing?

  • Assign appropriate ICD–10-CM codes, mapping to risk adjustment models as applicable
  • Assign Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes
  • Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines
  • Comply with HIPAA laws and regulations
  • Support chart audit processes, including audit provider and vendor documentation of ICD-9 and ICD-10 codes to ensure adherence with Center for Medicare & Medicaid Services (CMS) risk adjustment guidelines, and act as a liaison between internal departments and external entities on regulatory data validation audits (including HHS RADV).
  • Perform root cause analysis to identify issues that may contribute to coding and documentation deficiencies.
  • Perform internal and external coding quality reviews to validate correct ICD-10-CM code assignments.
  • Maintain quality and production standards required by company - all medical coders must maintain minimum QA passing requirements. Quality expectations are 95% accuracy on all projects.
  • Remain current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements

The Position Requirements:

  • Active certified coder certification (CRC, CPC, CCS, CCS - P) through AHIMA or AAPC
  • Minimum 3 years of experience as a certified coder
  • Minimum 3 year of risk adjustment experience
  • A minimum of 2 years experience Risk Coding Commercial Charts
  • Ability to code using an ICD-10-CM code book
  • Computer proficiency (including MS Windows, MS Office, and the Internet
  • High-speed Internet access

What other skills/experience would be helpful to have?

  • Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation
  • Prior experience with ACA HHS IVA RADV projects
  • Strong clinical knowledge related to chronic illness diagnosis, treatment and management
  • Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred)
  • Reliability and a commitment to meeting tight deadlines
  • Personal discipline to work remotely without direct supervision
  • Exemplary attention to detail and completeness
  • Strong organization, interpersonal, and customer service skills
  • Written and oral communication skills
  • Analytical skills

This is a remote, work from home position. You may be located anywhere within the US.

Required Experience Level

Senior Level

Minimum Education

High School

Minimum Experience Required

4-6 years

Required Travel

No required travel