1 value based coder ii jobs found in Boston

Outpatient Clinical Documentation Specialist The Risk Adjustment CDS will provide clinically based prospective concurrent and retrospective reviews of medical records for WellSense of members enrolled in value-based agreements to evaluate risk adjustment capture based on clinical documentation. The Risk Adjustment CDS will review risk adjustment gap lists for members including suspect conditions and perform chart reviews to determine clinical validity of open gaps. The Risk Adjustment CDS will utilize Physician documentation queries to communicate clinical indicators to Physicians/Other Qualified Health Care Providers in preparation for up-coming visits and/or in identifying patients that need to be seen for a visit. The goal of the risk adjustment reviews includes facilitation of appropriate physician documentation of care delivery to accurately reflect patient severity of illness and risk of mortality. Specific reviews are both determined internally and by requirements/requests...