
Certified Coder - Risk Adjustment (Hybrid in San Diego)
- San Diego, CA
- $23.41-41.83 per hour
- Permanent
- Full-time
- Generates reports for department workflow, production, quality monitoring and performance improvement
- Participates in formulating improvement initiatives/solutions and assists with execution
- Reviews AWVs and other charts for HCC diagnoses and quality codes and processes them into the tracking programs
- Recommends training opportunities and participates in provider training as needed
- Audits and interfaces with outside coding vendors
- Participates in webinars, conferences and conducts research as needed to stay abreast of IHA/NCQA/CMS requirements
- Serves as the user expert for software systems. Audits software accuracy from time to time and participates in testing
- Attends user meetings and reports systems issues to the vendor
- Tracks and submits audit data for program compliance
- Performs other duties as assigned
- Coding Certification
- 3+ years of experience in the healthcare industry
- Experience working with CPT and ICD-9 codes and reading claims forms/reports
- Knowledge of managed care concepts and healthcare delivery systems; understanding of health insurance industry and products
- Excellent organizational and interpersonal skills
- Organized self-starter with good follow through. Ability to work with changing priorities and varying deadlines
- Solid computer literacy, including competence with database and spreadsheet programs. Microsoft Office products familiarity