[Hiring] Certified Risk Adjustment Coding Specialist @Trinity Health

Role Description

The primary purpose of this position is to assign ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical records and providing education on documentation to support HCCs.

This is a fully remote position. Work hours will be 8 to 4:30 or 7 to 3:30 Eastern. Training will take place in person in Livonia, MI for one week (expenses paid). Onsite training is required for the position and would take place during the 2nd week of employment.

What you will do:

• Evaluate medical records to identify diagnoses and procedures and accurately assign and sequence ICD and CPT codes.
• Abstract and validate information, seeking out validating information as needed.
• Conduct documentation spot checks and respond to audit feedback.
• Ensure timely, accurate client care documentation for billing.
• Monitor and inform manager of records that are not completed timely.
• Investigate and take appropriate action for records that are not coded, billed, or rejected.
• Stay updated on coding guidelines and reimbursement requirements.
• Maintain participant confidentiality and abide by HIPAA guidelines.
• Assure site staff compliance with federal/state and accreditation regulations through record review, case conferencing, and communication.

Qualifications

• High school diploma or equivalent required; 2 years of completed college coursework preferred.
• Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC, or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA.
• Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC; if not obtaining, must obtain within one year if hired.
• Two years of experience in a risk adjustment coding environment required.
• Demonstrated ability to verify and validate HCCs.
• Demonstrated knowledge and ability to work with providers on education and guidance.
• Demonstrated knowledge of medical terminology, human anatomy and physiology, and disease processes.
• Strong communication, problem-solving, customer service, critical thinking, and organizational skills.
• Comprehensive proficiency with Microsoft product suite (MS Word, Excel, PowerPoint, etc.); ability to use other software as required to perform the essential functions of the job.
• Ability to prioritize workload.
• Position may require occasional travel to home office in Livonia, MI or other supported locations.

Benefits

• Comprehensive benefits including 1st Day medical coverage, dental, vision, paid time off, 403B, and educational assistance.
• Access to daily pay and employee referral incentives.
• Supportive environment with a patient-centered focus.
• Opportunities for professional development.

Company Description

Trinity Health PACE provides high-quality care to seniors in the communities we serve. Our interdisciplinary team offers comprehensive services, allowing seniors to remain independent at home. We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity.