Risk Adjustment Coder

Job Summary:

The ProFee CDS will work with providers to improve clinical documentation, ensuring accurate reflection of patient acuity, complexity, and risk profiles for billing and coding purposes. This role includes pre-visit support, post-visit reviews, and provider education.

Key Responsibilities:

• Pre-Visit Support: Review patient records to identify potential diagnoses, focusing on HCCs and chronic conditions.
• Post-Visit Review: Analyze documentation gaps and ensure proper reflection of patient acuity, E/M levels, and medical decision-making.
• Collaboration & Education: Work with providers to clarify documentation, provide 1:1 feedback, and coordinate training on coding best practices. Educate teams on proper documentation and compliance.

Qualifications:

• Education: Associate degree required.
• Certifications: CCS-P, CPC, CRC, or equivalent (RN/LPN optional).
• Skills: Extensive clinical knowledge, critical thinking, project management, and excellent communication skills.
• Experience: Proficiency in EMR systems (EPIC preferred) and coding applications (Excel, Word, PowerPoint).
• Knowledge: Strong understanding of HCCs, CMS guidelines, and clinical documentation best practices.

Essential Responsibilities:

• Support pre-visit chart reviews and identify documentation improvement opportunities.
• Develop and deliver provider education on coding, diagnosis selection, and documentation.
• Maintain ongoing feedback to providers and stay current with industry guidelines.

Medix is acting as an Employment Agency in relation to this vacancy.