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Certified Risk Adjustment Coder (CRC), Senior Director
Location
United States
Posted
17 days ago
Salary
0
Seniority
Lead
No structured requirement data.
Job Description
Certified Risk Adjustment Coder (CRC), Senior Director
Ankura
Role Description Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, and analytic skills. Our Senior Directors use their experience and knowledge related in coding, revenue cycle, and clinical operations, along with their project management capabilities, to contribute to complex investigations, whistleblower lawsuits, internal investigations, payer/provider disputes, and acquisition due diligence, among others. Responsibilities: - Review, analyze, and code diagnoses based on information in a patient's medical record according to specific guidelines for each project. - Evaluate compliance with established ICD-10 CM, third party reimbursement policies, regulations, and accreditation guidelines. - Communicate effectively with internal and external stakeholders according to project requirements. - Work with Project Managers to understand client needs and develop project work plans accordingly. - Understand Healthcare Compliance concepts, issues, and how to research and access regulatory guidelines and reference materials. - Draft clear and concise analyses of medical record review and coding findings. - Ensure successful completion of project deliverables as assigned and within the desired timeframe. - Work collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships. - Identify opportunities for cross-practice collaboration. - Proven writing and presentation skills and has a keen sense of attention to detail. - Communicate findings of concern with the team and Project Manager as they are identified. - Can independently deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas. Qualifications - Certified in Risk Adjustment Coding (CRC) with at least five (5) recent years of experience in HCC/Risk Adjustment and/or RADV Audit Methodology or related experience. - Associate’s or Bachelor’s degree preferred, but not required. - Strong understanding of clinical terminology, disease processes, anatomy, and pharmacology. - Intermediate to advanced understanding of claims processing procedures, state and federal regulations, and Medicare Part D requirements. - Excellent written and verbal communication skills, ability to work in a remote environment, and time management skills. - Prior success in managing small projects and teams and able to work on multiple client projects simultaneously, if needed. - Ability to work in a fast-paced environment while maintaining high quality. - Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings. - Understands the importance of attorney-client privileged and confidential communication. - Willingness to travel when needed. - Willingness to perform a variety of skill-based tasks related to risk adjustment work. - Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future. Company Description Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. If you have a disability and believe you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email accommodations@ankura.com or call toll-free +1.312-583-2122. This email and phone number are created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned.
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