Risk Adjustment Analyst

Job Summary

A company is looking for a Risk Adjustment Analyst- HIM OP CDI.

Key Responsibilities

• Analyze and audit medical records for payer audits under Value Care contracts
• Review and reorder Hierarchical Condition Categories (HCC) for claim generation
• Conduct pre-visit medical record reviews and create queries to support clinical documentation

Required Qualifications, Training, and Education

• High school diploma or GED required
• Successful completion of the OP CDI Proficiency Test
• One of the following certifications: AHIMA, AAPC, CPC, CRC, ACDIS, RN, LPN, NP, PA, or MD
• Minimum of twelve (12) months of OP coding or nursing experience in an ambulatory care setting
• Strong knowledge of medical record documentation requirements and coding guidelines