Risk Adjustment Coordinator

🕒 Agosto 12

🐊 Florida – Remoto

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💵 $25 - $32 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🎲 Riscos

👻 Score fantasma 23%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Baptist Health

Baptist Health

10.000+ funcionários

🏥 Saúde

🤝 Sem Fins Lucrativos

Healthcare • Non-profit

A Baptist Health é a maior organização de saúde sem fins lucrativos do sul da Flórida. Ela opera 12 hospitais, com mais de 29. 000 funcionários, 4. 500 médicos e cerca de 200 centros ambulatoriais, unidades de atendimento de urgência e consultórios médicos nos condados de Miami-Dade, Monroe, Broward e Palm Beach. O sistema inclui centros de excelência renomados em tratamento de câncer, cardíaco e vascular, neurologia e cuidados ortopédicos, e é apoiado por filantropia e uma missão baseada na fé. A Baptist Health enfatiza a qualidade clínica, segurança do paciente, desenvolvimento da equipe e cuidados orientados para a comunidade.

Descrição

• Support the Director of risk coding and other team professionals with pre- and post-visit review analysis for provider practices • Provide risk coding education to healthcare providers to improve practice risk scores • Represent the department and health system professionally with co-workers, hospital administrators, physicians, Medicare beneficiaries, and others • Work closely with other departments to achieve favorable outcomes • Perform chart review and up-coding workflows • Coordinate projects to ensure success of goals within the CIN organization • Support the mission, vision, values, and strategic goals of Baptist South Florida

🎯 Requisitos

• High School, Cert, GED, Trn, Exper. • Required completion of an accredited certified coding specialist program • AAPC Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), and/or Certified Professional Medical Auditor (CPMA) • CPMA certification must be obtained within 1 year of hire • 2+ years of clinic or hospital experience and/or managed care experience • 1+ years of experience in Risk Adjustment and HEDIS/Stars • Minimum required experience: 5 years • Ability to interpret, analyze, and abstract data/documentation • Comprehensive knowledge of ICD-10-CM codes, Category II codes, COA measures, CMS documentation requirements, state and federal regulations, compliance, reimbursement, and risk-adjustment payment models • Ability to identify HCC improvement opportunities and educate clinical providers on documentation, compliance, and coding guidelines • Intermediate proficiency in MS Office, including Excel, PowerPoint, and Word • Ability to defend coding decisions during internal and external audits • Strong organizational skills and ability to exercise judgment and initiative • Ability to work in a continuously changing environment • Bachelor's of Science degree preferred

🏖️ Benefícios

• Career growth and development opportunities, with clear pathways and ongoing support • Comprehensive health and wellness resources • Wellness program that can help employees eliminate their medical plan deductible • Tuition reimbursement

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