Risk Adjustment Coding Specialist in Maitland, FL at Adventist Health System Corporate Office

Date Posted: 8/30/2018

Job Snapshot

  • Job Schedule
  • Location:
    Maitland, FL
  • Job Category
  • Date Posted:
  • Job ID:
  • Job Function
    Other Non-Clinical Professional
  • Travel
  • Shift
  • AHS Zone
    2-Legacy System
  • Organization
    Adventist Health System Corporate Office

Job Description

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for a Risk Adjustment Coding Specialist position that will be based in our Physician Enterprise department. This position is based at our Corporate office in Altamonte Springs, FL. 

The Medicare Risk Adjustment Coding Specialist coordinates and supports retrospective and concurrent chart reviews in addition to education and chart retrieval for Health Plan audits and reports.  Uses knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.

Specific job duties 

•        Review and assess documentation and accurately translates chronic conditions into the appropriate diagnosis code from inpatient and outpatient medical records 

•        Extracts data for Health Plan reports

•        Inputs data collected from HCC programs

•        Coordinates audits of Provider coding data

•        Responsible for scheduling of audits

•        Sends Provider the list for chart reviews and provides follow-up communication

•        Assists in obtaining medical records from Providers to support audits requested by Health Plans

•        Assists in coordinating Physician and staff training sessions 

Knowledge and Skills Requirements:

•  High level of interpersonal and communication skills necessary to establish rapport with physicians and other healthcare providers.

•     Basic MS Office (Word, Outlook, Excel and PowerPoint) knowledge

•     Ability to perform the following: Faxing, scanning, record storage, archiving records for storage 

•     Regulatory background and risk adjustment/ Hierarchical Condition Categories (HCC) knowledge  (Preferred)  

Education and Experience Requirements:

•     Minimum of three years of healthcare experience

•     Minimum of 3 years’ experience in HCC 

•     Prior risk adjustment and medical record review experience 

•     Strong ambulatory background with a focus on diagnostic coding

•     Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing and various healthcare payers

Licensure, Certification or Registration Requirements:

•    CPC (Certified Professional Coder)

Required Competencies:

•        Business Partnering: Promotes collaboration and the sharing of ideas and perspectives with other internal functions and stakeholders

•        Develops Others: Recognizes colleagues’ strengths and development opportunities and provides them with ongoing feedback and coaching

•        Develops Self: Understands own strengths and development needs, learns from experience, and owns personal development

•        Knows the Business: Understands how the business works and can identify sources of value, efficiency, and effectiveness

•         Manages Change: Anticipates and drives change in order to meet organizational goals

•        Manages Quality and Risk: Understands and applies quality assurance and risk management procedures in all areas of work performed

•        Manages to Results: Contributes to the successful realization of goals and demonstrates accountability for goal realization

•        Subject Matter Expertise: Possesses deep knowledge and specialized skill set pertaining to the job function

If this position sounds like a great match for your skills set and experience, Please apply online now!

Position Location:  
Job:  Other Non-Clinical Professional
Organization:  Adventist Health System Corporate Office
Primary Location:  US-FL-Maitland
Schedule:  Full-time
Shift:  Day
Job Level:  Entry Level
Education Level:  None
Travel:  No
Job Posting:  Jul 11, 2018, 1:40:40 PM

Location | Organization | Category | Job Function