Porter · 13 hours ago
Risk Adjustment Coder
Detroit, MI
Full-time
Remote
Mid, Senior Level
5+ years exp
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Responsibilities
Assign accurate ICD-10, CPT, and CPT II codes based on documentation from in-home assessments, ensuring compliance with CMS risk adjustment and quality guidelines.
Manage the provider query process to clarify documentation and ensure the completeness and accuracy of patient diagnoses, particularly related to chronic conditions.
Handle multiple clients with varying coding requirements, maintaining high standards of accuracy and adapting to specific client guidelines.
Utilize coding clinics and other reference materials to provide providers with targeted feedback and education on improving documentation and coding accuracy.
Conduct regular audits to monitor coding quality and adherence to internal and external standards.
Maintain a minimum of 98% coding accuracy to meet performance expectations and ensure compliance.
Stay current with coding standards, risk adjustment methodologies, and CMS regulatory changes to ensure ongoing compliance and optimal coding practices.
Collaborate with clinical teams to review documentation and provide insights on areas for improvement in coding and documentation.
Support coding education initiatives by creating and delivering training materials to providers, particularly focused on improving documentation practices.
Maintain confidentiality and ensure full compliance with HIPAA regulations.
Qualification
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Required
Certification in medical coding (e.g., CPC, CRC) required.
Minimum 5 years of experience in risk adjustment coding, with specific experience in in-home assessments.
Expertise in managing provider queries and improving provider documentation through coding feedback.
Proficiency in using coding clinics and reference tools for accurate coding and provider education.
Strong knowledge of CMS risk adjustment and quality initiatives, including Hierarchical Condition Categories (HCCs).
Experience with electronic medical records (EMR) and coding tools.
Excellent communication skills, with the ability to collaborate with providers and clinical teams to drive coding improvements.
Strong attention to detail, prioritizing coding quality and compliance.
You must reside in the US
Preferred
Experience in coding audits and providing actionable feedback to providers.
Knowledge of healthcare reimbursement models and regulations impacting risk adjustment coding.
Prior experience in telehealth or in-home care settings.
Benefits
Competitive wage and benefits package
Opportunities for professional growth and continuing education
A supportive, collaborative work environment
Company
Porter
Porter is an end-to-end logistics platform designed to help businesses optimize their last-mile delivery operations.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$131.95MKey Investors
LightrockInnoVen CapitalMahindra Rise
2022-01-01Series Unknown
2021-10-25Series E· $99.88M
2020-04-11Series D· $18.38M
Leadership Team
Uttam Digga
Co-Founder & CEO
Pranav Goel
Co-Founder and Executive Vice Chairman
Recent News
2024-10-22
Dominor Investment
2024-10-11
Company data provided by crunchbase
