Medicare Risk Adjustment and Coding Consultant


Delmar, NY

Industry: Healthcare


Less than 5 years

Posted 276 days ago

  by    Lee Salinis

This job is no longer available.

Judge Healthcare is currently seeking a Medicare Risk Adjustment and Coding Consultant

This is a Field Based permanent position with 75% travel. 2 positions available one in Newark, NJ and the other in Albany, NY

This job will have the following responsibilities: 

  • Assists providers in understanding the CMS-HC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding. 
  • Assist providers in understanding the Medical Condition Assessment Incentive Program and Medicare Stars quality and CMS - HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding  
  • Supports the providers by ensuring documentation supports the submission of relevant ICD -10 codes and CPTII procedural information in accordance with national coding guidelines and appropriate reimbursement requirements  
  • Provides thorough, timely and accurate consultation on ICD-10 and/or CPT 2 codes by providers or practice clinical consultants  
  • Refers inconsistent or incomplete patient treatment information/documentation to coding quality analyst, provider, supervisor or individual department for clarification/additional information for accurate code assignment  
  • Provides ICD10 - HCC coding training to providers and appropriate staff  

Qualifications & Requirements:

  • 1+ years of experience in Risk Adjustment and HEDIS/Stars  
  • Must have Bachelor?s degree (preferably in Healthcare or relevant field)  
  • Have CPC (CRC additionally preferred but will need to be attained within 6months of hire)
  • Knowledge of EMR for recording patient visits  
  • Previous experience in management position in a physician practice  
  • 1+ year of experience coding in health care facility  
  • Knowledge of billing/claims submission and other related actions

Interested?Apply today!