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Strive Health · 1 day ago

Analyst, Risk Adjustment Coding

Denver, CO

Full-time

Hybrid

Mid, Senior Level

$66K/yr - $77K/yr

5+ years exp

Strive Health is focused on transforming the kidney care system through comprehensive coordinated care. The Analyst, Risk Adjustment Coding is responsible for supporting the clinical team and Nephrologists by providing risk adjustment education and clinical documentation support, ensuring compliance with coding guidelines and improving patient outcomes.

Health CareInformation TechnologyMedicalmHealth

No H1B

Responsibilities

Delivers value to Strive and its beneficiaries enrolled in Risk Adjusted government programs (MA, ACO, ACA, CKCC), using skills including but not limited to: HCC (Hierarchical Condition Category) Coding, medical coding, clinical terminology and anatomy/physiology, CMS coding guidelines, and RADV Audits

Works closely with physicians, team members, quality, and compliance partners at enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding

Supports all Strive risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories

Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements

Performs HCC coding on projects for MA, ACA, and ESRD. Ability to quickly flex between coding projects, including retro and prospective, with different MA, ESRD, and ACA HCC Models

Works independently in various coding applications and electronic medical record systems to support departmental goals

Qualification

CPC certificationCRC certificationHCC CodingICD-10-CMCMS coding guidelinesMedical codingClinical terminologyAnatomy/physiologyRADV AuditsMS Office SuiteElectronic Medical RecordsEncoderPresentation skillsCommunicationTeamworkOrganizational skills

Required

Active CPC (Certified Professional Coder) or CRC (Certified Risk Adjustment Coder) License

5+ years combined of related education, experience, or certification

Certified Risk Adjustment (CRC) certification OR Certified Professional Coder (CPC) certification required

Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Ability to travel and be onsite to meet business needs

Preferred

5+ years experience using ICD-10-CM, 2+years' experience with risk adjustment training geared toward physicians

Expert in coding and documentation guidelines, knows how to develop strong relationships with clinicians, and is an effective, strong communicator

Successful candidates will also have extensive presentation experience in the following areas: ICD-10-CM, CPT and HCPCS

Extensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes

Expert knowledge of Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance

MS Office Suite, Electronic Medical Records, Encoder, and other software programs and internet-based applications

Benefits

Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits.

Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts.

Financial & Retirement Support – Competitive compensation with a performance-based discretionary bonus program, 401k with employer match, and financial wellness resources.

Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves.

Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend.