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Risk Adjustment Medical Coder
Remote – US
Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.
Work Location: Fully Remote – U.S.
Change Healthcare is offering flexible opportunities in the medical field as a Risk Adjustment Medical Coder. In this role, you will identify members’ health conditions and assign and map codes to risk adjustment models, so health plans have appropriate payments to cover care.
Whether you’re looking for a side gig and supplemental income, or simply want to gain more training and experience in your field, this is a chance to boost your earnings potential on a flexible schedule and help transform the healthcare industry, from provider to patient.
This position reports to a Risk Adjustment Manager at the top level and with Clinical Advocacy team as point of contact.
- Assign appropriate ICD10-CM codes and mapping to risk adjustment models
- Assign Change Healthcare Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes
- Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adhere to official coding guidelines
- Comply with HIPAA laws and regulations
- Maintain quality and production standards required by company – all medical coders must maintain minimum QA passing requirements based on HCC scoring model (HCCx < or equal to 5 and HCCm < or equal to 5)
- Remain current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements
- Active certified coder certification (CRC, CPC, CCS-P) through AHIMA or AAPC (CCA, CPC-A not accepted)
- At least two years of risk adjustment coding experience
- Ability to code using an ICD-10-CM code book (without using an encoder)
- Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation
- Strong clinical knowledge related to chronic illness diagnosis, treatment and management
- Computer proficiency (including MS Windows, MS Office, and the Internet
- High-speed Internet access, a home computer with a current Windows operating system, an internet application, and Adobe Acrobat 6.0 or better
- Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred)
- Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts)
- Personal discipline to work remotely without direct supervision
- Analytical skills
Working Conditions/Physical Requirements:
- General office demands
- 100% work from home
- Flexible work schedule (20 to 40 hours per week)
- Per chart compensation and paid training
- W2 tax classification
- Assigned advocate to help with admin topics
California / Colorado / New Jersey / New York / Rhode Island / Washington Residents Only:
- The applicable base pay for your state is listed below. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, Change Healthcare offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with Change Healthcare, you’ll find a far-reaching choice of benefits and incentives.
The base pay range for this position is $0.00 – $0.00
Diversity, Equity & Inclusion:
- At Change Healthcare, we include all. We celebrate ersity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
- Business Resource Groups (BRGs) play a central role in advancing ersity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs.