Ambulatory Risk Adjustment Coding Specialist

Hourly Pay Range:

Position Highlights

• Position: Ambulatory Risk Adjustment Coding Specialist
• Location: Skokie, IL
• Full Time
• Hours: Monday-Friday, [hours and flexible work schedules]

Brief Overview:

Our Ambulatory Risk Adjustment Coding Specialist I plays a key role in identifying HCC codes within physician outpatient visits and ensuring they are coded accurately and to the highest specificity. They additionally will verify that documentation requirements are met to validate the HCC diagnosis code. Working closely with the ambulatory clinical documentation specialist (CDS), they will clinically verify the accuracy of HCC codes. Using compliant query guidelines, the coding specialist will query the physician should documentation need clarification or specification. The coding specialist is expected to maintain current knowledge of the ICD-10-CM codes and guidelines and meet minimum productivity requirements outlined by team leadership. 

What you will do:

• Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented, resulting in the correct CMS-HCC risk score
• Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education
• Responsible for partnering with ambulatory clinical documentation specialists and physicians to properly code patient charts to ensure appropriate risk adjustment
• Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
• Assists the coding team leads with onboarding new coding specialists to the role as needed.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
• Consistently maintain a minimum 95% accuracy on coding quality audits
• Meet minimum productivity requirements as outlined by the project terms
• Utilizes technical coding expertise to assign appropriate ICD-10-CM diagnosis codes, as well as assist in appropriate assignment of risk adjustment
• Maintains advanced knowledge of coding all HCC diagnoses from the medical record in accordance with the ICD-10-CM coding guidelines
• Assists with and completes special project work as assigned by Ambulatory Clinical Documentation Leadership

What you will need:

• Education: High School Diploma required, Associates Degree preferred
• Certifications: CRC required within 6 months of hire
• Experience: 2 years experience working in healthcare or professional business environment

Benefits (For full time or part time positions):

• Premium pay such as shift, on call, holiday and more based on an employee’s job (For eligible positions)
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities