Senior Risk Adjustment Coding Specialist (Hybrid)

The Opportunity

Join us in tackling healthcare for rural America! We’re seeking a Senior Risk Adjustment Coding Specialist who is passionate about having a positive societal impact and using technology for good – solving issues of health inequity for communities that have been perennially underserved.

The Senior Risk Adjustment Coding Specialist plays a critical role in ensuring the accuracy and compliance of Medicare & Medicaid risk adjustment coding processes. You will educate clinicians and support staff about proper coding and documentation practices specific to Medicare & Medicaid risk adjustment. This role aims to improve the accuracy of diagnosis coding, directly affecting the quality of care and appropriate reimbursement.

What You'll Do:

• Auditing and Feedback: Conduct regular audits of medical records, coding, and documentation to identify areas of improvement. Provide feedback and coaching to clinicians to address deficiencies.
• Documentation Improvement: Collaborate with clinicians and support staff to identify opportunities for improving documentation to support accurate coding, risk adjustment, and compliance.
• Coding Guidelines: Stay updated with the latest CMS (Centers for Medicare and Medicaid Services) risk adjustment guidelines and regulations to ensure education materials and training programs are current.
• Coding Accuracy: Promote and maintain accurate and complete coding practices that reflect the severity and complexity of patients' conditions to optimize risk adjustment factors.
• Compliance: Ensure adherence to all regulatory requirements, including Medicare, Medicaid, and CMS guidelines, and provide guidance on avoiding fraud, waste, and abuse in coding and documentation.
• Quality Improvement: Collaborate with quality improvement teams to integrate risk adjustment coding best practices into healthcare processes and improve the overall quality of care.
• Communication: Communicate changes in risk adjustment coding policies and guidelines to staff, as well as assist in resolving coding-related issues.

What you bring:

• 3 years of experience in medical coding, healthcare education, or a related field, with a strong focus on Medicare risk adjustment
• Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) certification
• In-depth knowledge of Medicare & Medicaid risk adjustment methodology and coding guidelines
• Strong understanding of ICD-10-CM diagnosis coding
• Excellent communication skills
• Familiarity with electronic health record (EHR) systems
• Knowledge of healthcare compliance, regulations, and billing practices
• Analytical and problem-solving skills

Bonus Points:

• Additional AAPC or AHIMA certification (RHIA, RHIT, CDIP, etc.)
• Approved instructor certification through AAPC or AHIMA
• Experience with risk adjustment technology solutions and risk adjustment vendors
• Previous experience building from the ground up on a small, fast-paced team

What Shapes Our Company:

• Deep commitment to one another, the people and communities we serve, and to care that enables everyone to achieve their best health
• Compassion and empathy
• Curiosity and an eagerness to listen
• Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
• Strong focus on the sustainability of our business and scalability of our services to maximize our reach and impact
• Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
• Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!

Benefits:

• Competitive salary and equity grant
• Unlimited Paid Time Off
• Comprehensive benefits package including medical, dental & vision insurance with 100% of monthly premium covered for employees
• Company-sponsored 401k plan
• Flexible working arrangement

The base salary range for this position is $85,000 - $95,000 annually. Compensation may vary outside of this range depending on a number of factors, including a candidate’s qualifications, skills, location, competencies, and experience. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work at Homeward Health. This role is eligible for an annual bonus, stock options, and a comprehensive benefits package.

At Homeward, a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you have yet to gain experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.

Homeward is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.