Risk Adjustment Coder

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

**CPC or CSS Certification and (2) years direct coding experience required**

Position Purpose: Coders will work daily reviewing medical records abstracting any HCCs that are able to be validated.  

• Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-10). Always coding to the highest level of specificity.

• Follows the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines.

• Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines.

• Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model.

• Ability to meet productivity and accuracy standards

• Ability to defend coding decisions to both internal and external audits.

• Complies with all policies and standards

• Ability to defend coding decisions to both internal and external audits.

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: Required A High School or GED

Preferred A Bachelor's Degree in a related field:
Candidate Experience: Required 2+ years of experience in professional coding experience either in a hospital or physician setting

Preferred Other Healthcare industry experience:
Licenses and Certifications: A license in one of the following is required:
Required Certified Professional Coder (CPC):
Preferred Certified Coding Specialist (CCS):

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act