Certified Risk Adjustment Coder (CRC), Senior Associate
Certified Risk Adjustment Coder (CRC), Senior Associate
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1 Vacancy
Job Description
Ankura is a team of excellence founded on innovation and growth.
Practice Overview:
Ankuras 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 analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankuras health care team is comprised of clinicians certified coders revenue cycle and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers payers and CMS. We combine in-depth operational compliance and clinical industry knowledge with exceptional data analytics information-gathering and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest and most prominent US health care providers payers and law firms.
Role Overview:
Our Sr. Associates 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 patients 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
Works with Project Managers to understand client needs and develop project work plans accordingly
Understands Healthcare Compliance concepts issues and how to research and access regulatory guidelines and reference materials
Drafts clear and concise analyses of medical record review and coding findings
Ensures successful completion of project deliverables as assigned and within the desired timeframe
Works collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships
Identifies opportunities for cross practice collaboration
Proven writing and presentation skills and has a keen sense of attention to detail
Communicates 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
Associates or Bachelors degree preferred but not required
Strong understanding of clinical terminology disease processes anatomy and pharmacology.
Intermediate to advanced understanding of in 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 Ability to be able 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.
For individuals assigned and/or hired to work in California Colorado or New York Ankura is required to include a reasonable estimate of the compensation range for this role. This compensation range is specific to the said markets and considers a broad range of factors including but not limited to skill sets experience and training licensure and certifications and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. The range does not include additional benefits outside of salary. At Ankura it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each role. A reasonable estimate of the current base pay range is between $85000 to $200000; this range is not a promise of a particular wage.
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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. Equal Employment Opportunity Posters 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 or call toll-free 1.. 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. Messages left for other purposes such as following up on an application or technical issues unrelated to a disability will not receive a response.
Required Experience:
Senior IC
Employment Type
Full-Time
