Senior Risk Adjustment Coding Compliance Analyst, Clinical

Job Description: • Executes Line 2 oversight of Risk Adjustment activities • Reviews medical records to assess proper extraction of medical diagnoses • Identifies and evaluates clinical documentation gaps, assesses risk levels • Collaborates with coding teams to improve documentation practices • Ensure coding accuracy by reviewing inpatient and outpatient medical records • Validate clinical documentation to support appropriate risk adjustment coding • Implement CMS risk adjustment guideline oversight • Conduct Line 1 gap analyses and provide clinical best practice recommendations • Provide expert guidance on CMS coding requirements, clinical documentation improvement (CDI) • Evaluate policies and procedures to ensure completeness, clinical accuracy, and adherence to current regulatory requirements Requirements: • High School Diploma or GED required • Bachelor's Degree Nursing, Healthcare Management, Business Management or related field preferred • 5+ years professional coding experience in a hospital or physician setting required • Experience in Managed care preferred • LVN, LPN or RN required • Certified Professional Coder (CPC) required • NP or PAN preferred • Certified Coding Specialist (CCS) preferred Benefits: • competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules Apply tot his job Apply To this Job