Risk Adjustment Coder
Core
Review ambulatory medical records to ensure accurate capture of clinical picture, severity of illness, and complexity for risk adjustment models.
Role type
Risk Adjustment Coder
Builds
Coded clinical data quality results and reports
Domain
Healthcare / Risk Adjustment
Required skills
Risk adjustment coding, Auditing, Electronic health record (EHR) navigation, Medicare Managed Care knowledge
Preferred skills
Medicare Advantage experience
Technologies
EHR/EMR systems
Responsibilities
Conduct concurrent, prospective, and retrospective reviews of clinical documentation, Evaluate accuracy and consistency of coded clinical data, Ensure compliance with federal, state, and county regulations, Participate in provider communication activities related to clinical documentation
