Outpatient Risk Adjustment Coder

The Prospective Outpatient Risk Adjustment Coder supports risk adjustment optimization activities that improve value-based care and population health by facilitating accurate capture of chronic conditions in the medical record, collecting data around provider documentation and coding practices, and identifying opportunities to close care gaps.

Working with the HCC Nurse Educator, the Ambulatory HCC Coordinator conducts prospective chart reviews to ensure chronic conditions are listed in medical record before provider visits and uses ICD-10 CM coding guidelines and risk adjustment model regulations to identify missed opportunities to address chronic conditions in retrospective chart reviews.

Collects data during reviews and runs reports from the population

health platform to identify areas to target for education and performance improvement. Works with primary care practice staff to schedule annual comprehensive visits.

Assists with coordinating risk adjustment education and performance improvement projects. Assists with other activities and projects as assigned.

Ideal candidate will have a combination of medical coding and clinical experience as an MA or LPN in an outpatient setting.

Position

Prospective Outpatient Risk Adjustment Coder

SCHEDULE :

• Monday Friday
• No weekends no holidays
• Business hours

LOCATION :

• Springfield, MA
• Once training has been completed, flexibility to become hybrid

REQUIREMENTS :

• High School / GED Nationally recognized Coding certification (such as CPC or CCS)
• Minimum of 3 years in payor or healthcare coding position
• with exposure to risk adjustment / HCC coding, or combination of clinical experience in medical practice and medical coding
• Microsoft Office including Excel
• ICD-10 CM Coding Guidelines and Regulations

PREFERRED :

• Associate's Degree ; Certified Risk Adjustment Coder (CRC); Certified Documentation Expert Outpatient (CDEO); CMA or LPN
• EHR (Cerner preferred)
• Prospective coding or risk adjustment coding; clinical experience in outpatient medical practice.

THE ADVANTAGES OF WORKING WITH BAYSTATE!

Excellent Compensation High-quality, low-cost medical, dental and vision insurance

Generous PTO up to 25 days in the first year, with scheduled earned increases

Continuing education support and reimbursement

First Time Home Buyers Financial Packages

Farm Share Memberships

403b retirement company match & annual company contribution increase based on years of service

Free money coach advice from a certified professional

Wellbeing programs that include but are not limited to mental, physical, and financial health

Pet, home, auto and personal insurance

Life insurance

Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!

Wellbeing programs that include but are not limited to mental, physical, and financial health

Baystate Health, western Massachusetts’ only academic center and tertiary care provider has a long and proud tradition of continuous learning and improvement.

We educate and train hundreds of healthcare workers every year and advance knowledge about new approaches to care. At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff.

We are committed to increasing diverse representation across our organization. Together our inspired and compassionate teams manage the whole health needs of all communities in need.

We strive to be the place where we can help you build the career you deserve apply today YOU belong at Baystate!

OUR COMPENSATION PHILOSOPHY

We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge / skills;

relevant experience and training; education / certifications / licensure; and other business and organizational factors.

This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.