Risk Adjustment Manager

Job Responsibilities

• Audit and coding review project management.
• Day to day management of medical record retrieval and scheduling of clinical review staff
• Development and implementation of internal and vendor policies and procedures
• Coding team Performance Management
• Train and coach certified coders and provider educators
• Maintains a strong and up to date understanding of ICD 10 coding rules and CMS Guidelines
• Subject matter expertise development and knowledge sharing with Nurse Practitioner staff and providers
• Development of Risk Adjustment provider and staff education and support materials
• Conducts clinical chart reviews, and assign or validates diagnostic or procedure codes for attestation. Encounter or claims

Skills and Experience

• Certification in Medical Coding and Billing with a minimum of 2 years of experience performing risk adjustment functions in a managed care setting required
• Project management experience preferred
• RN, or MPH/MPA, preferred
• Experience with supervising staff preferred
• Candidate can work remotely, and live outside of New York State