Medicare Risk Adjustment Coding Consultant - Remote reputed company San Diego, CA Area

Job title: Medicare Risk Adjustment Coding Consultant - Remote reputed company San Diego, CA Area in San Diego, CA at reputed company Company: reputed company Job description: reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.You will be in the field consulting with providers approximately 4 days per week and the other 1 day will be working from home. This is a Monday - Friday position. Candidates must reside in San Diego or the surrounding area.This position requires travel up to 75% reputed company the state. Relocation is not provided for this position.If you are located in San Diego, CA, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities:

• Partners with Healthcare Advocates in the field and will be assigned providers to embed based on data analysis where they need support / training on improving documentation and coding accuracy
• Utilizes analytics to identify and reputed company providers for Medicare Risk Adjustment training and documentation/coding resources
• The Medicare Risk Adjustment Coding Consultant will be responsible for facilitating and/or performing an audit of the providers’ medical chart to ensure appropriate documentation exists to support the diagnoses submitted appropriately
• Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
• Supports the providers by ensuring documentation supports the submission of relevant ICD-10-CM codes in accordance with national coding guidelines and appropriate reimbursement requirements
• Routinely consults with medical providers to clarify missing or inadequate record information and to determine

appropriate diagnostic and procedure codes * Ensures member encounter data (services and disease conditions) is being accurately documented and reputed company relevant diagnosis codes are captured

• Provides customized documentation improvement education, including corresponding ICD-10-CM codes to providers and appropriate staff
• Develops and presents documenting & coding presentations and training to large and small groups of clinicians, practice managers and certified coders developing training to fit specific provider's needs
• Educates providers and staff on documentation & coding guidelines and changes as it relates to Quality and Risk Adjustment to ensure compliance with state and federal regulations
• Performs chart note analysis and provides timely feedback to providers on a regularly scheduled basis
• Provides measurable, actionable solutions to providers that will result in improved accuracy for documentation and coding best practices
• Reviews selected medical documentation to determine if assigned diagnosis and procedures codes are appropriately assigned
• Collaborates with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:

• Certified Professional reputed company (CPC) certification and/or Certified Risk Adjustment reputed company
• 4+ years of experience with physician billing and/or coding
• Experience in CMS-HCC Risk Adjustment
• Experience managing/maintaining relationships with physicians/ hospitals/ health systems
• Ability to work effectively with common office software, coding software, EMR and abstracting systems
• Proficient in reputed company, reputed company, PowerPoint and Outlook
• Ability to travel reputed company state up to 75% to client locations
• Reside in San Diego, CA or are willing to relocate to the area without relocation assistance

Preferred Qualifications:

• CPC-I and/or CPMA certifications from reputed company
• 4+ years of clinic or hospital and/or managed care experience
• Experience in a leadership position in a physician practice
• Proven knowledge of billing/claims submission and other reputed company actions
• Proven solid communication and presentation skills
• Proven relationship building skills with clinical and non-clinical personnel

*reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy.The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives.At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission.Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Expected salary: $71600 - 140600 per year Location: San Diego, CA Apply for the job now! Apply for this job