Risk Adjustment Coding Specialist - VBC Operations and Transformation

Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient. Utilizes knowledge of official coding guidelines (ICD-10, CPT, HCPCs), Hierarchical Condition Categories (HCC), M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards, Risk Adjustment Factor (RAF) scoring, and AHIMA/ACDIS physician query brief. Provides education to providers on the importance of diagnosis specificity. May participate in developing, presenting, and disseminating provider communication and other activities related to clinical documentation.