Risk Adjustment Coder
Remote
Full Time
Entry Level
We are seeking an experienced Risk Adjustment Coder to join our growing team supporting our IRIS (Intus Revenue Integrity System) product. This role combines clinical knowledge, coding expertise, and analytical skills to ensure accurate diagnosis capture for our value-based care clients.
Intus Care is a leading healthcare analytics platform dedicated to transforming care for PACE programs. By synthesizing complex healthcare data, we help identify risks, visualize trends, and optimize care delivery. Our platform empowers care providers to prevent high-risk events while equipping executives with the insights needed to make data-driven decisions based on comprehensive clinical and operational information. Our mission is to drive high-value, multidisciplinary care for older adults through actionable data.
In addition to our analytics solutions, we offer a range of consulting and technical support services for both new and established PACE programs as they grow and adapt to meet the needs of their communities.
What We Offer:
Company Core Values:
Salary Range: $75,000-$80,000
Location: USA-based Remote
Intus Care is an equal opportunity employer and prohibits discrimination against persons of any kind on the basis of race, color, religion, gender, sexual orientation, nation of origin, age, disability, and genetics.
What We Do:
Intus Care is a leading healthcare analytics platform dedicated to transforming care for PACE programs. By synthesizing complex healthcare data, we help identify risks, visualize trends, and optimize care delivery. Our platform empowers care providers to prevent high-risk events while equipping executives with the insights needed to make data-driven decisions based on comprehensive clinical and operational information. Our mission is to drive high-value, multidisciplinary care for older adults through actionable data.
In addition to our analytics solutions, we offer a range of consulting and technical support services for both new and established PACE programs as they grow and adapt to meet the needs of their communities.
In This Role You Will:
- Perform comprehensive medical record reviews and risk adjustment coding using ICD-10-CM guidelines.
- Validate diagnostic coding accuracy through natural language processing (NLP) assisted technology.
- Review medical records to identify potential missed opportunities through a prospective review process.
- Support real-time query processes to clarify diagnoses and identify high-risk conditions.
- Contribute to quality assurance and compliance initiatives.
- Collaborate with clinical teams to improve documentation practices.
- Assist in developing and maintaining coding guidelines and protocols.
- Participate in coding accuracy and consistency reviews.
- Maintain a quality assurance score of 95% or above.
Required Qualifications:
- Current CPC, CCS, or RHIT certification AND current CRC certification.
- 5+ years of medical coding experience with risk adjustment coding background.
- High School diploma required; Associate's or Bachelor's degree preferred.
- Demonstrated experience working remotely and independently.
- Strong understanding of healthcare regulations and risk adjustment requirements.
- Clinical knowledge with proven ability to analyze medical record documentation.
- Proficiency in applying coding conventions and official guidelines.
- Must pass required coding examination.
- Proficiency with electronic medical record systems.
- Experience with coding and auditing software.
- Strong computer skills and ability to learn new technologies.
- Must reside in the United States of America.
Preferred Qualifications:
- Additional certification in CPMA, CPCO, or CDEO.
- Clinical documentation improvement experience.
- Experience with Medicare Advantage or PACE programs.
- Background in quality assurance or compliance auditing.
Key Competencies:
- Exceptional attention to detail and accuracy.
- Strong analytical and problem-solving abilities.
- Excellent written and verbal communication skills.
- Ability to work independently while contributing to team goals.
What We Offer:
- A chance to be a part of a trailblazing team in healthcare technology.
- Competitive salary package.
- Comprehensive benefits including health, dental, and vision insurance.
- A collaborative, inclusive, and dynamic work environment.
- Opportunities for professional growth and development.
Company Core Values:
- Take Ownership for Your Responsibilities and Outcomes
- Think With Data First
- Be Passionate About Impact
- Take Strides Toward Growth and Innovation
- Be Supportive Of Each Other
Salary Range: $75,000-$80,000
Location: USA-based Remote
Intus Care is an equal opportunity employer and prohibits discrimination against persons of any kind on the basis of race, color, religion, gender, sexual orientation, nation of origin, age, disability, and genetics.
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