Job Description:

This Position is an entry-level role in Risk Adjustment and will learn to demonstrate general proficiency in the areas of Risk Adjustment Coding for highly regulated government insurance programs such as Medicare Advantage (MA), Medicaid, and the Affordable Care Act (ACA). This analyst will audit approved clinical documentation post-visit to ensure accurate coding practices according to general and risk adjustment coding guidelines as established by the Centers for Medicare and Medicaid (CMS) and Health and Human Services (HHS). Continued employment is dependent on the candidate obtaining CRC Certification from AAPC within 1 year of hire.

Job Essentials          

1. Reviews clinical documentation to monitor coding practices and ensure accurate coding and reimbursement.  Ensures review decisions are in line with Centers for Medicare and Medicaid (CMS) as well as internal department guidelines.

2. Supports higher level analysts in their responsibilities and research and all internal department functions and processes, as needed.

3. Maintains knowledge of coding workflow and use of available technology.

4. Documents chart review results in a Risk Adjustment database for reporting purposes.

5. Participates in governmental risk adjustment audits for CMS/HHS on a limited basis         

6. Effectively manages workload and responsibilities.

7. Develops subject matter expertise. 

8. Complies with HIPAA law to maintain data privacy and security.

9. Completes all continuing education requirements needed for certification earned on an ongoing basis.

10. Works with software programs (Microsoft Office products, coding programs, Electronic Medical Records (EMR)).

11. Maintains functional knowledge of general medical terminology, medical acronyms, anatomy and physiology.

Minimum Qualifications

National Professional Coding Certification from AHIMA or AAPCSome work or education experience in medical coding or healthcareFunctional knowledge or medical terminology, acronyms, anatomy, and physiologyDemonstrated basic-level experience with Microsoft Office productsDemonstrated excellent written and verbal communication skillsCompletion of an internal CRC training and competency evaluation no later than one year of hireCertified Risk Adjustment Coder (CRC) through AAPC obtained within 1 year of hire

Preferred Qualifications

CRC certification already obtainedICD-CM diagnosis coding experience

Physical Requirements:

Physical Requirements

To see the physical requirements needed to perform the essential functions of this job, please click here.

Interact with othersOperate computers and other equipmentRead monitors and documentsRemain sitting or standing for long periods of time

Location:

Nevada Central Office

Work City:

Las Vegas

Work State:

Nevada

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$26.84 - $42.28

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado and Montana based caregivers.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.