Risk Adjustment Coder Remote

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At VillageMD, we are committed to helping patients achieve greater health by delivering the most effective, accessible and efficient healthcare in the world through partnership with primary care physicians. We're in a unique position to impact everyone in primary care from independent, family-owned practices to world-class health systems. As part of achieving this goal, as a Risk Adjustment Coder at our organization you will be an expert in structured clinical assessments, accurate and specific documentation, and population health workflows.

Integral to our VillageMD-Georgia team, Risk Adjustment Coders are responsible for identifying gaps in submissions, ensuring correct clinical documentation and identifying areas of coding improvements for CMS Medical Billing, Risk Adjustment and Quality Incentive programs. Risk Adjustment Coders will also own informatics responsibilities for providers before, during, and after patient visits. He/she will leverage informatics to educate primary care physicians and APPs on opportunities to improve their overall coding performance.

What you might do in your first year?

  • Review charts, code chronic disease that meets HCC and Risk Adjustment criteria.
  • Validate missed coding opportunities.
  • Demonstrate the ability to appropriately use coding principles to code to the highest specificity and complies with CMS regulations and company goals and policies.
  • Ensure compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.
  • Review patient charts to ensure accurate coding.
  • Communicate with physicians about documentation and coding.
  • Special review projects as assigned for analytics.
  • Coach, facilitate, solve work problems and participate in the work of the team.

What will make you successful here?

  • Keen focus on results and can navigate within ambiguity while maintaining a high-level of humility
  • Familiarity with Electronic Health Records documentation methodologies
  • Exposure to healthcare operations; primary care preferred
  • Demonstrated achievement with change management and quality improvement initiatives
  • Exceptional communication skills
  • Proven success in building relationships and establishing credibility with doctors, nurses and other clinical staff
  • Ability and willingness to take direction and be a member of a team providing patient care
  • Basic level of medical knowledge and/or a willingness to learn quickly
  • Excellent job attendance

What you bring to VillageMD?

  • Bachelor’s degree in health information management, science, nursing or comparable field preferred, but not required
  • Professional Coding Certification such as CCS, CPC or CRC, required within 6 months of employment

At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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We are in the heart of downtown Chicago - accessible to all trains and plenty of food/drink options nearby!

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