4 risk adjustment coder jobs found

Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of...

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference....