Associate II, Risk Adjustment Coder

Job Description:

About the Role

The Associate II, Risk Adjustment Coder will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. They will work closely with our Value Services, Clinical, and Compliance teams to leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation.

Responsibilities 

• Serve as the subject matter expert on Medicare HCC documentation requirements and ICD-10-CM coding guidelines 

• Audits Coder I for accuracy of captured risk adjustable codes

• Maintain professional communication with provider teams

• Ensure adherence to Cityblock’s coding guidelines and any necessary updates are shared across the teams.

• Develop a foundational understanding of the coding tool and processes to assign proper Risk Adjustment codes.

• Comply with all legal requirements regarding coding procedures and practices

Requirements for the Role 

• HS Diploma

• Certification Required: CPC

• 3 years experience (2+ Risk Adjustment (HCC) coding and 1+ years of auditing)

• HCC Coding

• Knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures. Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology

• Proficiency with Google Suite and Microsoft Office

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for sick leave.  The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is: 

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Covid 19 Update - Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine.  Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock.  Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption.  Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements.  The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

The COVID-19 pandemic has severely impacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.