Coder 1-Risk Adjustment

The Coder 1-Risk Adjustment is responsible for concurrent, prospective, and retrospective clinical documentation review within the Risk Adjustment Data Validation (RADV) process, focusing on the severity of illness, provider documentation, and HCC diagnoses. The role involves ensuring accuracy, completeness, and adherence to CMS guidelines.

Requirements

• Bachelor's degree in Health Information Management or equivalent clinical/healthcare degree
• 2+ years of combined clinical/medical experience
• 1+ year of Risk Adjustment coding specific experience
• Knowledge of ICD-10-CM coding conventions and H/D coding
• Experience with CMS Risk Adjustment Data Validation (RADV)