On Belay Health Solutions logo
On Belay Health Solutions

Empowering independent physicians to practice medicine and impact the health of their communities how they've dreamed

Medicare Risk Adjustment Specialist I

Location

Massachusetts

Posted

2 days ago

Salary

$25 - $28 / hour

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

Medicare Risk Adjustment Specialist I

On Belay Health Solutions

• Review and validate AI-identified risk adjustment coding opportunities within medical records • Assess clinical documentation to determine the appropriateness of proposed diagnoses and HCC submissions • Support the quality assurance process for AI-assisted chart reviews by identifying coding discrepancies, false positives, and missed opportunities • Develop feedback loop with On Belay’s Head of Risk Adjustment Coding and physician offices On Belay supports, including but not limited to: Identification of quality improvement opportunities in individual physician coding • Any other related duties assigned at manager’s discretion

Job Requirements

  • High school diploma or GED required
  • Associates degree preferred
  • Active coding certificate required
  • AAPC or AHIMA coding certification preferred
  • Required: CCS-P (Certified Coding Specialist- Physicianbased) or CPC (Certified Professional Coder)
  • Preferred: CRC (Certified Risk Adjustment Coder)
  • Experience in a primary care setting highly preferred
  • Knowledge of medical terminology and medical chart review required
  • Two (2) or more years’ experience of hierarchical condition categories (HCC)
  • Knowledge of ICD-10-CM Official Guidelines for Coding and Reporting
  • Knowledge of AHA Coding Clinic and authoritative coding resources
  • Knowledge of Microsoft Office suite, primarily Excel (specifically Pivot Tables, sort and filter functions)
  • Strong time management skills required
  • Ability to navigate within various EMRs (Electronic Medical Records), Cerner Preferred
  • Strong interpersonal, communication (verbal, non-verbal and listening) skills
  • Ability to remain productive under time constraints and meet deadlines critical to the business.

Benefits

  • Innovative, revolutionary environment
  • Great culture with a strong sense of mission and community
  • Eleven (11) Paid Holidays
  • Lavish PTO accrual
  • Advancement opportunities & professional skills training
  • Strong referral bonus program
  • And more!

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