Risk Adjustment Coding Specialist supporting risk adjustment efforts through chart reviews and provider education. Estimated travel up to 75% in Inland Empire region, specifically LA or Orange County.
EH
Hybrid Senior Medical Coding Education Associate – Hospital / Professional Claims
Posted 2 months ago
About the role
- Medical Coding Education Associate Sr conducting claims data analysis for Elevance Health. Engaging with providers to ensure accurate coding and documentation guidelines with hybrid work requirements.
Responsibilities
- Responsible for the comprehensive analysis of complex claims data
- Generate refined and industry-relevant concepts that govern the prosperity of the company across all business lines and client interactions
- Engage with providers and other internal/external stakeholders to ensure proactive collaboration in reviewing coding and documentation guidelines
- Examine medical records and various documentation to ensure the precision of code assignment
- Research, validate, and stay abreast of medical coding and billing issues, trends and changes in regulations and industry standards
- Develop concept ideas to support the goals of the department and organization
- Launch education concepts
- Furnish providers with comprehensive feedback on current year coding guidelines and industry expertise
- Assist other associates with their documentation and education discussions
- Execute a detailed review of medical records to confirm documentation justifies the level of service provided
- Assist other associates with the completion of medical record reviews and respond to provider inquiries
- Complete appeals requests from providers
Requirements
- Requires an AA/AS degree
- Minimum of 6 years of experience working with ICD-9/10CM, CPT, and HCPCS coding
- Current, valid, active, and unrestrictive RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Cert Coding Specialist and/or CPC Cert Professional Coder
- Proficiency with MS Outlook, Word and Excel strongly preferred
- Experience in facility and professional health insurance reimbursement, medical coding or coding audits strongly preferred
- Understanding of health data analytics preferred
- Requires strong oral and written communication skills
- Excellent analytical and critical thinking skills
- Strong decision-making skills
- Ability to manage multiple tasks in a demanding work environment
- Appreciation of diversity
- High energy level
- Self-motivation
Benefits
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Incentive and recognition programs
- Equity stock purchase
- Comprehensive benefits package
- Wellness programs
- Financial education resources
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