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Transforming the health of the communities we serve, one person at a time.
Risk Adjustment Coding Compliance Analyst – Non-Clinical
Location
Missouri
Posted
125 days ago
Salary
$56.2K - $101K / year
Seniority
Mid Level
Job Description
Risk Adjustment Coding Compliance Analyst – Non-Clinical
Centene Corporation
• Executes Line 2 oversight of Risk Adjustment activities • Identifies compliance risks, auditing coding practices, adherence to CMS guidelines • Ensures coding accuracy by reviewing inpatient and outpatient medical records • Apply ICD-10, AHIMA, Coding Clinic, and company’s coding guidelines • Review and appropriately challenge coding decisions based on current industry guidelines • Conduct Line 1 gap analysis and provide best practice recommendations • Provide guidance on CMS coding requirements and industry best practices • Assess risk levels in coding data and recommend mitigation strategies • Evaluate policy and procedures to ensure completeness and adherence to current requirements • Support remediation efforts for identified non-compliance issues.
Job Requirements
- High School Diploma or GED required
- Associate's Degree in related field preferred
- 2+ years Professional coding experience in a hospital, physician, or health plan setting required
- 5+ years Professional coding experience in a hospital, physician, or health plan setting preferred
- Managed care experience preferred
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required
- Certified Risk Adjustment Coder (CRC) preferred
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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