Sr Risk Adjustment Coder

A Brief Overview

The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs : including but not limited to Medicare Advantage Risk Adjustment.

Locations

Stanford Health Care - University Healthcare Alliance

What you will do

• Risk Adjustment Review
• May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing
• Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses.
• Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes.
• Inquire with clinicians the recommended HCC diagnosis for chart addendum.
• Collaborating with other departments to address coding updates and support risk adjustment programs.
• Compliance Reporting
• Tracking and reporting review results that will be used to develop education and training materials on risk adjustment coding and / or documentation best practices.
• Assist with the implementation of emerging coding and compliance laws and regulations and assist with implementing privacy policies.
• Maintain current knowledge of risk adjustment coding guidelines by conducting research, reading professional publications, and maintaining professional networks. Attending coding seminar, webinars and medical organization meetings.
• All other duties as assigned including department-specific functions and responsibilities :
• Performs other duties as assigned and participates in organization projects as assigned.
• Adheres to safety, P4P’s (if applicable), HIPAA and compliance policies.

Education Qualifications

Experience Qualifications

Required Knowledge, Skills and Abilities

Licenses and Certifications

Physical Demands and Work Conditions

Physical Demands

Lifting

Carrying

Working Environment

Blood Borne Pathogens

Travel Requirements

These principles apply to ALL employees :

SHC Commitment to Providing an Exceptional Patient & Family Experience

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and / or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale : Generally starting at $44.13 - $57.36 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.