Risk Adjustment Medical Coder

Who we are: -

At CitiusTech, we constantly strive to solve the industry's greatest challenges with technology, creativity, and agility. With over 8,500 healthcare technology professionals worldwide, CitiusTech powers healthcare digital innovation, business transformation, and industry-wide convergence for over 140 organizations through next-generation technologies, solutions, and products. We aim to accelerate the transition to a human-first, sustainable, and digital healthcare ecosystem with the world's leading Healthcare and life sciences organizations and our partners.

Here is an opportunity for you to make a difference and collaborate with global leaders to shape the future of healthcare and positively impact human lives.

JD - Risk Adjustment Medical Coder

Job Summary:

• We are looking for a highly skilled and experienced Risk Adjustment Medical Coder to join our team. Candidate should have extensive experience in data extraction, medical coding, HCC and risk adjustment models.
• This role involves reviewing and analysing patient medical records/health insurance claims, ensuring accurate risk adjustment coding, and maintaining compliance with medical coding policies and guidelines.

Key Responsibilities:

• Review and interpret medical records to identify relevant ICD-10 diagnosis codes, with a focus on HCC and Risk Adjustment.
• Apply appropriate ICD-10 codes to patient records based on documented diagnoses, ensuring accurate risk adjustment coding.
• Ensure all coded data accurately reflects the services provided, per regulatory requirements and risk adjustment guidelines.
• Identify and report potential areas of risk or non-compliance related to risk adjustment coding.
• Interact with physicians and other healthcare providers to clarify information and obtain additional documentation when necessary for accurate risk adjustment coding.
• Stay current on ICD-10 and HCC coding guidelines & risk adjustment methodologies.
• Conduct audits and coding reviews to ensure documentation accuracy and precision, particularly in the context of risk adjustment.
• Assist with training and education of other coders and healthcare staff on risk adjustment coding practices.

Qualifications:

• High School diploma or equivalent; Associate degree in a healthcare-related field (Preferred).
• Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), Other Relevant Certifications - Certified Coding Specialist (CCS)/Certified Inpatient Coder (CIC).
• Minimum of 2 years of progressive coding experience, with a strong focus on risk adjustment coding.
• In-depth knowledge of ICD-10-CM, CPT, SNOMED and other coding guidelines, with expertise in risk adjustment models.
• Strong understanding of medical terminology, anatomy, and physiology.
• Excellent analytical and problem-solving skills, particularly in the context of risk adjustment.
• Proficiency in using medical coding software and electronic health records (EHR) systems.
• Strong attention to detail and accuracy in risk adjustment coding.
• Effective communication and interpersonal skills.

Preferred Skills:

• Experience in multiple specialties within medical coding.
• Extensive familiarity with risk adjustment models and methodologies.
• Ability to work independently and as part of a team.
• Experience with training and educating healthcare providers on risk adjustment coding practices.

Location: -

• Irving, TX(Remote)

Life at CitiusTech

We focus on building highly motivated engineering teams and thought leaders with an entrepreneurial mindset, centered on our core values of Passion, Respect, Openness, Unity, and Depth (PROUD) of knowledge. Our success lies in creating a fun, transparent, non-hierarchical, diverse work culture that focuses on continuous learning and work-life balance.

Rated by our employees as the Great Place to Work for according to the Great Place to Work survey. We offer you a comprehensive set of benefits to ensure that you have a long and rewarding career with us.

Our EVP

Be You Be Awesome is our EVP and it reflects our continuing efforts to create CitiusTech as a great place to work where our employees can thrive, both personally and professionally. It encompasses the unique benefits and opportunities we offer to support your growth, well-being, and success throughout your journey with us and beyond. Together with our clients, we are solving some of the greatest healthcare challenges and positively impacting human lives. Welcome to the world of Faster Growth, Higher Learning, and Stronger Impact.

Join CitiusTech. Be You. Be Awesome.
To learn more about CitiusTech, visit