Risk Adjustment Coding Specialist

Job Summary

A company is looking for a Risk Adjustment Coding Specialist I.

Key Responsibilities

• Conduct risk adjustment coding and quality assurance validation for various programs
• Perform prospective medical record reviews and concurrent outpatient claim diagnosis coding
• Execute retrospective medical record and provider response reviews

Required Qualifications, Training, and Education

• Relevant coding certification (e.g., CPC, CCS)
• Experience in risk adjustment coding and compliance
• Knowledge of medical terminology and coding guidelines
• Understanding of healthcare regulations and documentation standards
• Familiarity with electronic health record (EHR) systems