Risk Coder

Job not on LinkedIn

🕒 May 19

🍂 Massachusetts – Remote

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💵 $50.2k - $57.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

👻 Ghost score 51%

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Logo of Community Care Cooperative (C3)

Community Care Cooperative (C3)

201 - 500 employees

Founded 2016

🏥 Healthcare

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

Community Care Cooperative (C3) is a rapidly growing non-profit created by Federally Qualified Health Centers (FQHCs) to strengthen primary care, improve financial performance, and advance racial justice. C3 unites health centers into FQHC-led accountable care networks, providing contracting, data, actuarial, and population-health capabilities to enable participation in value-based payment and care models. It also operates affiliates that deliver technology services (Community Technology Cooperative), pharmacy operations and 340B support (Community Pharmacy Cooperative), and a statewide telehealth consortium to help health centers integrate telehealth into primary and behavioral care.

📋 Description

• Perform retrospective and prospective risk coding reviews for outpatient primary care practices across Massachusetts • Complete provider training • Serve as an expert on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and MassHealth Risk Adjustment guidance • Complete record reviews using common EHRs, especially Epic, NextGen, Centricity, and eCW • Assist in compiling and delivering project reports and facilitate provider-facing interactions • Complete internal audits according to quality assurance protocols • Facilitate allowable bill modifications to ensure accuracy, interacting extensively with FQHC billing and operations staff • Assist in chart preparation for providers before appointments • Communicate observed documentation trends to the provider education team • Use population health reporting tools to identify patients and conditions requiring review and improvement • Identify opportunities for FQHC risk score improvement • Report to the Manager, Risk Coding and interface with Practice Transformation Managers and FQHC staff • Perform other duties as assigned

🎯 Requirements

• 0-5 years of risk coding experience • 0-5 years of medical billing experience in an outpatient setting, preferably in primary care, pediatrics, or behavioral health • In-depth knowledge of medical terminology, anatomy, physiology, and disease process • Knowledge of electronic health record systems: Epic, NextGen, Centricity, and eCW preferred • Expertise in Medicaid and/or Medicare risk adjustment models • Billing compliance expertise required • Familiarity with Excel • Familiarity with the MassHealth ACO program • Familiarity with Federally Qualified Health Centers • Certified Risk Coding (CRC) Certification through AAPC required • Must be vaccinated consistent with applicable law

🏖️ Benefits

• Vaccination consistent with applicable law required for infection control compliance

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