Risk Coder

🕒 May 19

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $50.2k - $57.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Community Care Cooperative (C3)

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2016

🤝 Non-profit

🤝 B2B

🌍 Social Impact

Non-profit • B2B • 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

• Serves as an expert on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and MassHealth Risk Adjustment guidance • Completes record review with a high degree of familiarity with common EHRs, especially Epic, NextGen, Centricity, and eCW • Assists in the compilation and delivery of project reports and facilitates provider-facing interactions • Completes internal audits per quality assurance protocols • Facilitates allowable modifications to the bill to ensure accuracy, involving extensive interaction with FQHC billing and operations staff departments • Assists in chart preparation for providers in advance of appointments • Communicates with provider education team on observed trends to improve documentation • Utilizes population health reporting tools to assist in the identification of patients and conditions in need of review and improvement • Identifies opportunities for FQHC risk score improvement • Performs 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 • Self-starter; exercises high degree of initiative, judgement, discretion and decision making to achieve objectives • Familiarity with Excel • Performs with great integrity and produces accurate work with close attention to detail, especially in the completion of final deliverables to internal and external stakeholders. • Certified Risk Coding (CRC) Certification through AAPC required