Risk Adjustment Coding Advisor

Job Summary

A company is looking for a Risk Adjustment Coding Advisor to join their team.

Key Responsibilities

• Recommend process improvements to enhance coding quality goals and outcomes
• Validate and troubleshoot Natural Language Processing (NLP) outputs from clinical documentation
• Oversee coding projects, including training third-party coding vendors and reviewing coding guidelines

Required Qualifications

• Bachelor's degree or equivalent experience
• Medical coding certification (RHIA, RHIT, CCS, CPC, or CRC) with 3-5 years of coding and auditing experience
• Working knowledge of risk adjustment models including CMS-HCC, HHS-HCC, and CDPS
• Experience with standardized clinical terminologies such as ICD-10 and CPT-4
• Strong understanding of anatomy, physiology, disease processes, and medical terminology