Risk Adjustment Coding Specialist verifying Medicare Advantage documentation for providers. Engaging with providers on coding requirements and conducting quality audits.
About the role
- Clinical & Coding Specialist-Senior responsible for reviewing coding and clinical decisions for complex cases. Supporting team training and audit processes at Independent Health in Buffalo, NY.
Responsibilities
- Review coding and clinical decisions on cases involving complex clinical presentation
- Aid in training other team members
- Evaluate appeals and share audit trends across the team
- Support the leadership in Hospital Audit in accomplishing all aspects of the audit plan
Requirements
- Associates degree required
- Bachelor’s degree preferred
- Minimum four (4) years of experience working in a clinical setting or utilizing coding systems (ICD-10 or PCS)
- Minimum one of the certifications: Certified Inpatient Coder (CIC), Registered Health Information Management Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN or LPN
- Knowledge of ICD-10-CM and ICD-10-PCS coding systems
- Coding audit experience in an inpatient setting preferred
Benefits
- First-class perks
- Generous paid time off
- Full range of benefits
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