About this opportunity
VIVA Health lists this Risk Adjustment Specialist opportunity in birmingham, Alabama. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Location: Birmingham, Alabama
Job Summary
The Risk Adjustment Specialist ensures all ICD-10 codes are documented for the assignment of valid and accurate HCCs for each record reviewed for submission to the Centers for Medicare & Medicaid Services (CMS). Other responsibilities include working suspect reports to identify unreported diagnosis codes and conducting chart audits on in-house records from other departments. This position will assist the Manager of Risk Adjustment with other projects as needed.
Why VIVA HEALTH?
VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.
VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.
Benefits
Comprehensive Health, Vision, and Dental Coverage
401(k) Savings Plan with company match and immediate vesting
Paid Time Off (PTO)
9 Paid Holidays annually plus a Floating Holiday to use as you choose
Tuition Assistance
Flexible Spending Accounts
Healthcare Reimbursement Account
Paid Parental Leave
Community Service Time Off
Life Insurance and Disability Coverage
Employee Wellness Program
Training and Development Programs to develop new skills and reach career goals
Employee Assistance Program
See more about the benefits of working at Viva Health -
Key Responsibilities Maintain thorough understanding of the risk-adjusted payment methodology; what can be submitted by the plan and how/when submission impacts CMS payments.
Demonstrate knowledge of ICD10 coding guidelines, medical terminology, disease processes, and pharmacology.
Interpret and demonstrate analytical and problem-solving ability in reviewing medical record documentation to accurately assign ICD10 codes.
Conduct chart reviews to identify all appropriate diagnoses based on CMS-HCCs and specific HEDIS measures.
REQUIRED QUALIFICATIONS : High School Diploma or GED
At least 3-5 years' experience with coding
Certified Coder (AHIMA or AAPC credentials)
Read and interpret handwritten and typewritten material
Excellent oral and written communications skills
Ability to work under pressure to meet deadlines with minimal supervision
Basic computer skills
PREFERRED QUALIFICATIONS: 2 or more years of college
Experience with hospital coding
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
Worksite address
birmingham, AL, 35275, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.