Risk Adjustment Specialist - REMOTE

We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its "Top 100 Places to Work."

Overview:

This is a REMOTE position.

Primarily responsible for providing expertise in reviewing and assigning accurate medical codes for diagnoses, with particular attention to appropriate capture of risk codes based on provider documentation and evidence in the medical record. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

Works independently utilizing advanced, specialized knowledge of medical codes and applicable risk models to assign and sequence appropriate diagnosis billing codes, in compliance with coding standards, in a timely manner.

Reviews recent patient encounters as assigned and prioritized. Reviews provider diagnosis coding for accuracy and provider documentation for support of selected codes. Queries/contacts providers for clarification/additional support as needed.

Reviews patient records prior to upcoming visits and/or retrospectively throughout the year as assigned and prioritized. Examines the medical record to extract applicable diagnostic risk codes, submitting them to providers/payers for review as appropriate.

Working knowledge of anatomy, physiology, and medical terminology necessary to correctly code provider diagnosis.

Ability to work cooperatively and effectively with physicians, coworkers, practice managers, quality and operations teams to drive results and resolve issues. Fosters a team approach and positive attitude to developing work processes and problem solving.

Adheres to basic ethical principles associated with the appropriate ICD-10 coding guidelines, government and insurance company reimbursements. Reports any observed questionable activities to the appropriate compliance officer or administrative manager.

Assist with data quality monitoring activities such as identifying and tagging appropriate records for ongoing studies of the Performance Improvement area.

Upholds and adheres to HIPAA regulations.

Maintains up-to-date knowledge of changes and regulations that affect risk coding. Shares leanings with fellow coders and risk coders within communities and across the Ministry.

Consistently meets or exceeds productivity and quality standards.

Ability to adapt and respond positively to change.

Qualifications:

• Experience: Minimum 6 months coding experience.
• Required Education: High School Graduate or GED
• Preferred Education: Associate's or Bachelor's Degree.
• Certifications: Certified Coder certification through AHIMA or AAPC

We Offer Great Benefits:

Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!

We're bringing to life a healing ministry through compassionate care.

At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.

What Makes You a Good Match for Mercy?

Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care - that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.

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