Apply on Employer Site

Strive Health · 12 hours ago

Analyst, Risk Adjustment Coding

United States

Full-time

Remote

Senior Level

$66K/yr - $77K/yr

5+ years exp

Strive Health is dedicated to transforming the kidney care system through early identification and comprehensive care. The Analyst, Risk Adjustment Coding plays a key role in supporting clinical teams by providing education and documentation support, ensuring compliance with coding guidelines, and improving risk adjustment capabilities.

Health CareInformation TechnologyMedicalmHealth

No H1B

Responsibilities

Supporting the Strive clinical team and partner Nephrologists by providing risk adjustment education and clinical documentation support

Supporting the growth and improvement of Strive’s risk adjustment capabilities by conducting training, education, and management of coding and documentation improvement program

Ensuring technical aspects of diagnostic and procedure coding follow CMS, NCQA, third party payers and other regulatory agencies

Monitoring assigned provider's documentation and coding

Educating assigned providers on CMS, AMA and Strive documentation and coding guidelines

Educating assigned ongoing education of ICD-10-CM to the providers

Performing provider queries and addendum requests based on CMA, AMA documentation and coding guidelines

Providing ongoing feedback and education to the clinical management team regarding accurate documentation to improve overall health outcomes for patients and continuity of care

Delivering value to Strive and its beneficiaries enrolled in Risk Adjusted government programs (MA, ACO, ACA, CKCC)

Working closely with physicians, team members, quality, and compliance partners at enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding

Supporting all Strive risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories

Supporting other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements

Performing HCC coding on projects for MA, ACA, and ESRD

Working independently in various coding applications and electronic medical record systems to support departmental goals

Qualification

CPC CertificationICD-10-CMHCC CodingCMS Coding GuidelinesMedical CodingClinical TerminologyAnatomy/PhysiologyPresentation SkillsCommunication SkillsTeamworkOrganizational Skills

Required

Active CPC (Certified Professional Coder) or CRC (Certified Risk Adjustment Coder) License

5+ years combined of related education, experience, or certification

Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Ability to travel and be onsite to meet business needs

Preferred

5+ years experience using ICD-10-CM, 2+years' experience with risk adjustment training geared toward physicians

Expert in coding and documentation guidelines, knows how to develop strong relationships with clinicians, and is an effective, strong communicator

Successful candidates will also have extensive presentation experience in the following areas: ICD-10-CM, CPT and HCPCS

Extensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes

Expert knowledge of Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance

MS Office Suite, Electronic Medical Records, Encoder, and other software programs and internet-based applications

Benefits

Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits.

Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts.

Financial & Retirement Support – Competitive compensation with a performance-based discretionary bonus program, 401k with employer match, and financial wellness resources.

Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves.

Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend.