Associate, Clinical Documentation Integrity (Risk Adjustment)

Responsibilities

• Reviews upcoming visits to validate persistent (chronic) conditions and raise potential suspect conditions for provider to assess
• Utilizes various systems to find clinical support to assist in closing risk adjustment gaps
• Ensures documentation rules, coding guidelines and company compliance guidelines are met
• Performs assessments of data to improve overall operations and identify opportunities for provider education and optimization
• Serves as a subject matter expert on Hierarchical Condition Category (HCC) documentation requirements and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding guidelines
• Develops and supports strong professional relationships with medical providers across the organization

Requirements

• 5+ years of overall experience
• 3+ years of Clinical Documentation Integrity (CDI) specific experience
• Medicaid documentation requirements understanding is a plus

Qualifications

We take into account an individual’s qualifications, skillset, and experience in determining final salary.

Benefits

• Health insurance
• Life insurance
• Retail benefits
• Participation in the company’s equity program
• Paid time off, including vacation and sick leave

Pay

The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.

Schedule

The expected salary range for this position is: $71,000.00 - $90,500.00 Annual