Risk Adjustment Coder – Valora Medical Group – Irving, TX

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Valora Medical Group is a visionary company focused on high-quality primary care services and consists of healthcare providers and professionals dedicated to the health and wellbeing of our patients. At Valora, we treat our patients like family.

With multiple locations throughout the Dallas-Fort Worth area, we understand that providing quality medical care and an exceptional patient experience across all our centers requires having an outstanding team.

We recognize the hard work that our team members put in and offer competitive pay, excellent benefits, and a dynamic work environment.

Job Summary:

The Risk Adjustment Coder will review patient medical records to assist the company’s healthcare providers in identifying and resolving issues related to incomplete or missing clinical documentation.

Essential Duties and Responsibilities:

  • Validate and abstract risk adjustment specific diagnosis codes utilizing a computer assisted coding platform and chart/document reviews.
  • Reviews medical records and billing history to determine if specific disease conditions were correctly billed and documented.
  • Responsible for sending daily and weekly reports supporting each medical office.
  • Implement process improvements that will maximize risk adjustment factor accuracy and appropriate documentation.
  • Adheres to all official coding rules and CMS guidelines for risk adjustment, and ensures accuracy, completeness, specificity and appropriateness of diagnosis information.
  • Assists with the completion of HEDIS chart reviews and facilitates the accurate and timely reporting of quality codes.
  • Train and mentor medical providers and relevant clinical staff regarding appropriate HCC coding/documentation and HEDIS measures.
  • Additional duties assigned by management

Qualifications/Education:

  • Bachelor’s Degree in healthcare or related field is preferred
  • 2+ Years coding experience and 1+ years of direct Risk Adjustment, CMS, HCC Model experience
  • Certified Professional Coder
  • Certified Risk Adjustment Coder (desired)
  • eCW experience is a plus
  • Experience with HEDIS is a plus
  • Understanding of Federal Medicare program, Medicare Advantage Plans, and the medical insurance industry
  • Must have effective written, verbal communication, and interpersonal skills
  • Ability to establish working relationships, resolve interpersonal conflicts, and apply basic staff etiquette in dealing with others
  • Ability to handle confidential information with discretion
  • Strong analytical skills with attention to detail
  • Ability to learn new procedures and adapt quickly to change
  • Innovative, motivated, organized, and team player
  • Follow through with commitments.
  • Ability to work independently
  • Proactive and self-starter.

EEO Statement:

Valora Medical Group, LLC is an equal opportunity employer and does not discriminate on the basis of race, color, religion, creed, sex, national origin, age, disability, pregnancy status, sexual orientation, gender identity, veteran status, marital status, genetic information, citizenship status, or other status protected by law. In compliance with the Immigration Reform and Control Act of 1986, we will hire only U.S. citizens and aliens lawfully authorized to work in the United States.

Job Type: Full-time

Pay: From $25.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Employee assistance program
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Ability to commute/relocate:

  • Irving, TX 75038: Reliably commute or planning to relocate before starting work (Preferred)

Application Question(s):

  • Please list the EMR systems you have experience with:
  • Valora Medical Group must adhere to the CMS mandate, requiring all healthcare workers to be COVID-19 vaccinated. Are you fully vaccinated? If yes, will you be able to provide proof of your vaccination? If no, do you plan on being vaccinated?
  • What is your desired pay rate?

Education:

  • Bachelor’s (Preferred)

Experience:

  • Medical Billers & Coders: 2 years (Preferred)

License/Certification:

  • Medical Coding Certification (Required)

Work Location: One location

Source: Indeed.com
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