About On Belay Health Solutions
About the role
On Belay supports this transformation to value-based care through holistic physician support and population health infrastructure, which includes Medicare Risk Adjustment education and support critical to managing our Medicare patients – many with complex chronic conditions – in a world-class model of care driven by motivated, passionate physicians. As a result of our efforts to provide the value-based contracts and the tools to support our physicians in those contracts, we are able to empower physicians to practice the way we all envision a care model should be – with ample time to truly understand our ambitions in life and provide guidance on how we can achieve those ambitions through a healthy life.
On Belay is seeking a motivated, passionate Risk Adjustment Specialist to enable this vision of care for our Medicare populations. This full-time, hourly position, with the expectation of 40 hours per week, will operate in a 100% remote capacity and is open to applicants living in the United States. We look forward to meeting interested applicants and mutually assessing fit in joining On Belay on our important mission to transform healthcare!
What you'll do
Chart review and ICD-10 diagnosis coding of risk adjustment eligible members
Review of medical records for accuracy of ICD-10 diagnosis codes
Review of accurate capture of medical severity of any applicable illness(es)
Clinical documentation integrity review and validation of risk adjustment diagnoses
Composing and sending compliant queries to providers
Identification of opportunities to improve individual patient risk adjustment accuracy
Identification of quality improvement opportunities in individual physician coding
Missed opportunities to accurately code patient condition(s)
Risk adjustment coding industry trends that may impact the success of On Belay’s risk adjustment program
Qualifications
High school diploma or GED required
Active coding certificate required. CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist- Physician-based) through AHIMA (American Health Information Management Association) or AAPC (American Academy of Professional Coders)
CRC (Certified Risk Coder) coding certificate required.
Clinical experience or current working knowledge of clinical documentation integrity/improvement
Minimum of five (5) years experience working in risk adjustment coding
Strong working knowledge of medical terminology, anatomy, physiology, and pharmacology
Strong working knowledge of hierarchical condition categories (HCC)
Strong working knowledge of ICD-10-CM Official Guidelines for Coding and Reporting
Strong working knowledge of the AHA Coding Clinic and authoritative coding resources
Strong knowledge of Microsoft Office suite, primarily Excel
Strong time management skills required
Ability to navigate within various EMRs (Electronic Medical Records)
Access to a remote work location with reliable internet and phone service
Strong interpersonal communication (verbal, non-verbal, and listening) skills
Ability to work under minimal supervision after the initial onboarding phase
Ability to remain productive under time constraints and meet deadlines critical to the business
Associate degree or higher
CCDS-0, CDIP, CCDS (Certified Clinical Documentation Specialist) certification
Two (2) or more years of experience in a primary care setting
Practice Transformation - Non Clinical
Remote (United States)
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