Analyst, Risk Adjustment Coding

What We Strive For

At Strive Health were driven by a purpose: transforming the broken kidney care system. Through early identification engagement and comprehensive coordinated care we significantly improve outcomes for people with kidney disease reducing emergency dialysis and inpatient utilization. Our high-touch care model integrates with local providers and uses predictive data to identify and support at-risk patients along their entire care journey. We embrace diversity celebrate successes and support each other making Strive the destination for top talent in healthcare. Join us in making a real difference.

Benefits & Perks

• Hybrid-Remote Flexibility Work from home while fulfilling in-person needs at the office clinic or patient home visits.
• Comprehensive Benefits Medical dental and vision insurance employee assistance programs employer-paid and voluntary life and disability insurance plus health and flexible spending accounts.
• Financial & Retirement Support Competitive compensation with a performance-based discretionary bonus program 401k with employer match and financial wellness resources.
• Time Off & Leave Paid holidays vacation time sick time and paid birthgiving bonding sabbatical and living donor leaves.
• Wellness & Growth Family forming services through Maven Maternity at no cost and physical wellness perks mental health support and an annual professional development stipend.
  

WhatYoullDo

TheAnalystRisk Adjustment Codingis responsible forsupporting the Strive clinical team and partner Nephrologists by providing risk adjustment education and clinical documentation support. This roleis responsible forsupporting the growth and improvement ofStrivesrisk adjustment capabilities by conducting training education and management of coding and documentation improvementprogram. TheAnalystensures technical aspects of diagnostic and procedure codingfollowCMS NCQA third partypayersand other regulatory agencies. They willmonitorassigned providers documentation and coding educate assigned providers on CMS AMA and Strive documentation and coding guidelines educate assigned ongoing education of ICD-10-CM to the providers andperform provider queries and addendum requests based on CMA AMAdocumentationand coding individualwill provide ongoing feedback and education to the clinical management teamregardingaccuratedocumentation to improve overall health outcomes for patients and continuity of role will report to the Sr. Director Risk Adjustment.

The Day to Day

• Deliversvalue to Strive and its beneficiaries enrolled in Risk Adjusted government programs (MA ACO ACA CKCC) using skills including but not limited to: HCC(Hierarchical Condition Category)Coding medical coding clinical terminology and anatomy/physiology CMS coding guidelines and RADV Audits.
• Works closely with physicians team membersqualityandcompliancepartners atenterprise and leadership toidentifyand deliver high quality andaccuraterisk adjustment coding.
• Supports all Strive risk adjustment projects tocomply withall CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories.
• Supports other keyobjectivesto drive capture of correct Risk Adjustment coding including documentation improvement provider education analyzing reports andidentifyingprocess improvements.
• PerformsHCC coding on projects for MA ACA and ESRD. Ability to quickly flex between coding projects includingretro andprospective with different MA ESRD and ACA HCC Models.
• Works independently in various coding applications and electronic medical record systems to support departmental goals.

MinimumQualifications

• ActiveCPC(Certified Professional Coder)orCRC (Certified Risk Adjustment Coder)License.
• 5 years combinedofrelated education experience or certification.
• Certified Risk Adjustment (CRC) certification OR Certified Professional Coder (CPC) certification required.
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60ms.
• Ability to travel and be onsite to meet business needs.

Preferred Qualifications

• 5 years experience using ICD-10-CM 2years experience with risk adjustment training geared toward physicians.
• Expert in coding and documentation guidelines knows how to develop strong relationships with clinicians and is an effective strong communicator.
• Successful candidates will also have extensive presentation experience in the following areas: ICD-10-CMCPTand HCPCS.
• Extensive knowledge of documentation and coding guidelinesestablishedby the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes.
• Expert knowledge of Federal laws and regulations including NCDs and LCDs affecting risk adjustment documentation and coding compliance.
• MS Office Suite Electronic Medical Records Encoderandother software programs andinternet-basedapplications.

About You

• Use acustomer focusedapproach in dealing with conflict and resolution of problems.
• Strong clinical assessment and critical thinking skills.
• Excellent verbal and written communication skills.
• Ability to work in a team environment.
• Flexibility and strong organizational skillsneeded.

Annual Base Salary Range: $66000 - $77000

Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability status protected veteran status or any other characteristic protected by law. Please apply even if you feel you do not meet all the qualifications. If you require reasonable accommodation in completing this application interviewing completing any pre-employment testing or otherwise participating in the employee selection process please direct your inquiries to

We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.

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