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Risk Adjustment Analyst

6/7/2025

N/A

Job Summary

A company is looking for a Risk Adjustment Analyst- HIM OP CDI.

Key Responsibilities
  • Analyze and audit medical records for payer audits under Value Care contracts
  • Review and reorder Hierarchical Condition Categories (HCC) for claim generation
  • Conduct pre-visit medical record reviews and create queries to support clinical documentation
Required Qualifications, Training, and Education
  • High school diploma or GED required
  • Successful completion of the OP CDI Proficiency Test
  • One of the following certifications: AHIMA, AAPC, CPC, CRC, ACDIS, RN, LPN, NP, PA, or MD
  • Minimum of twelve (12) months of OP coding or nursing experience in an ambulatory care setting
  • Strong knowledge of medical record documentation requirements and coding guidelines

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