About the role:

As a Value Based Care (VBC) Coder for you will be:

• Concurrent review to ensure care teams achieve accurate and specific clinical documentation
• Compliant query generation, as needed
• Escalate any educational opportunities to improve clinical documentation in compliance with ICD-10 CM coding guidelines, internal protocols, and CMS and payer guidelines

Responsibilities will include:

• Concurrent review and feedback after face-to-face visit (in person or via telehealth) to ensure coding and documentation accurately captures patient health status
• Compliant query generation when conflicts or clarification is needed in documentation, prior to claim submission
• Corrected claim generation when compliant note amendments are completed
• Provide guidance to field staff and practices regarding general coding, documentation and risk adjustment best practices
• Partner with internal stakeholders to improve reporting and analytics tools to drive improvements in the accuracy and completeness of clinical documentation and diagnosis coding
• Reviews annual mapping updates of ICD-10 CM crosswalk from CMS Website
• Other duties as assigned

What makes you a fit for the team:

• You are excited to work in a startup environment, with the ambiguity and shifting priorities that might come with it at times
• You are willing to go the extra mile no matter what
• You are passionate about our mission to improve the lives and healthcare outcomes of marginalized communities

Desired skills and experience:

• Required
  • Current certification as a Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent
  • 3+ years of recent, relevant work experience in medical coding, preferably in risk adjustment
  • Thorough understanding of medical coding guidelines and regulations including compliance, reimbursement, and the impact of diagnosis documentation on risk adjustment payment models
  • Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts
• Preferred
  • Experience in pre-visit planning and provider education
  • Experience with athenahealth
  • Experience with GSuite and Google applications