[Hiring] Senior Coding Analyst @Altais

Role Description

Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients.

The Senior Coding Analyst will divide their time coding medical records for the purpose of HCC coding, including our annual health assessments, and working with our physicians on clinical documentation improvement. The Senior Coding Analyst, Risk Adjustment provides support and coding expertise to all programs that support risk adjustment and data validation efforts for our Medicare Advantage line of business, along with other ad hoc and long-term projects assigned by the leadership team in Clinical Performance. These projects impact revenue and prepare us for health plan, CMS and HHS audits. The Senior Coding Analyst, Risk Adjustment will provide analytics, education, trainings to provider offices, and serve as the subject matter expert for all HCC coding initiatives, policies and procedures that adhere to our organizations coding guidelines and compliance standards. The position will interact with physicians, the provider network, and internal stakeholders within the organization (e.g. Provider Relations, Clinical Quality). The ability to develop and maintain key relationships across the company and provider network will be critical. The position may evolve to include Commercial; Medicaid, Quality and Social Determinants of Health (SDoH) capture as needed.

You will focus on:

• Reviewing, auditing, and coding medical records for the purpose of HCC reimbursement, training, education, and compliance.
• Meeting daily productivity targets around HCC coding with 95% accuracy as well as office outreach and education.
• Auditing and reviewing medical documentation for appropriate ICD-10 and HCC coding and documentation.
• Querying physicians when code assignments are not straightforward, or documentation is unclear.
• Reviewing HCC and ICD-10 codes annually for accuracy and implementing changes.
• Assisting physicians and providers with questions and problems related to HCC coding and documentation.
• Supporting organization on all levels of HCC coding audits (Internal Data Validation (IDV), Risk Adjustment Data Validation (RADV), Office of Inspector General (OIG), Department of Managed Healthcare (DMHC).
• Serving as a resource to team members and physician offices.
• This role may be responsible for 50% or more time meeting production standards.

Qualifications

• High school diploma or GED and equivalent of 2 years of relevant HCC coding experience.
• 3 - 5 years’ experience of professional medical coding credentials (CPC, CRC and or similar).
• 3 – 5 years’ experience in HCC coding and auditing (chart review).
• 1 or more years’ experience in EPIC EMR software.
• 3 – 5 years’ experience in Medicare Risk Adjustment.
• 1 or more years’ project management and/or coordinating detailed projects or activities.

Preferred Qualifications

• Bachelor’s degree from an accredited school.
• 6 or more years’ experience in a clinic setting, working directly with physicians and staff setting.
• 6 or more years’ experience and knowledge of Commercial and Medicaid coding, SDOH.

Compensation

The Compensation for this position is $24.88 to $29.86/hour. In addition, we provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

Benefits

• Excellent medical, vision, and dental coverage.
• 401k savings plan with a company match.
• Flexible time off and 9 Paid Holidays.

Values

• Compassion: We act with empathy and a deep respect for the challenges faced by physicians and their patients.
• Community: We foster a culture of collaboration with physicians, patients across the healthcare ecosystem, and among our teams.
• Leadership: We lead with integrity and vision, setting the standard for excellence in physician support and healthcare innovation.
• Excellence: We are relentlessly focused, results-driven, and accountable for delivering measurable value to physicians and the patients they serve.
• Agility: We embrace change as a constant and respond swiftly to the evolving needs of the healthcare industry.