Certified Professional Coder

Job Summary

A company is looking for a Value Based Care Coder.

Key Responsibilities

• Conduct concurrent review and provide real-time education support during patient visits to ensure accurate coding and documentation
• Generate compliant queries for documentation clarification prior to claim submission
• Collaborate with internal stakeholders to enhance reporting and analytics tools for improved clinical documentation accuracy

Required Qualifications

• Current certification as a Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent
• 3+ years of recent, relevant experience in medical coding, preferably in risk adjustment
• Thorough understanding of medical coding guidelines, compliance, and risk adjustment payment models
• Subject matter expertise on the CMS HCC Risk Adjustment program and its impact on value-based contracts