Risk Adjustment Documentation & Coding Educator, CRC Required

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🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $70k - $85k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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Privia Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

💳 Fintech

💰 $450M Post-IPO Equity on 2021-04

Healthcare • Fintech

Privia Health is a national physician platform transforming the healthcare delivery experience. They provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and population health management programs, Privia collaborates with health plans, health systems, and employers to better align reimbursements to quality and outcomes.

📋 Description

• Conduct virtual risk adjustment training with individual and large provider groups • Educate providers on risk adjustment and current documentation and coding requirements • Deliver presentations on ICD-10-CM, CPT, and HCPCS • Analyze coding performance indicators and audit error rates to target high-risk clinical areas and providers • Conduct prospective and retrospective medical record chart audits • Validate ICD-10-CM coding and HCC assignments • Ensure audited charts meet CMS documentation requirements, including MEAT criteria • Use compliant provider queries to clarify conflicting, ambiguous, or incomplete documentation • Generate audit findings, error reports, and accuracy scores • Analyze claims data and electronic health records to identify care gaps and chronic-condition recapture opportunities • Identify training priorities and schedule provider trainings • Train providers on effective EHR workflows for coding and documentation • Meet key performance indicators and quarterly objectives • Act as the internal subject matter expert and escalation point for risk adjustment and coding documentation • Follow documentation and coding guidelines and legal requirements to ensure regulatory compliance • Travel approximately four times per year for summits and education

🎯 Requirements

• 5+ years’ experience with coding and documentation • Certified Professional Coder (CPC) required • Certified Risk Adjustment Coder (CRC) required • Knowledge of federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance • Extensive knowledge of CMS and AMA documentation and coding guidelines for diagnostic and procedural codes • Proficiency with MS Office Suite, Electronic Medical Records, Encoder, Coding Clinic, G-Suite, software programs, and internet-based applications • Valid unrestricted driver’s license • Reliable vehicle • Ability to maintain patient, team member, and employer confidentiality • Compliance with all HIPAA regulations • Minimum 5 MBPS download speed and 3 MBPS upload speed for remote work

🏖️ Benefits

• Annual bonus targeted at 10% • Medical insurance • Dental insurance • Vision insurance • Life insurance • Pet insurance • 401(k) • Paid time off • Wellness programs • Remote work • Expense reimbursement for employees who regularly work from home offices • Approximately 4 trips per year for summits/education

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