Ambulatory Risk Adjustment Coding Specialist II

NorthShore University HealthSystem
paid time off, tuition reimbursement
United States, Illinois, Skokie
4901 Searle Parkway (Show on map)
Mar 11, 2025
Position Highlights: Position: Ambulatory Risk Adjustment Coding Specialist II Hourly Pay Range: $24.86-$37.29/hour. The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors Location: Skokie, IL Full Time/Part Time: Full time Hours: Monday-Friday, [hours and flexible work schedules] A Brief Overview: Our ambulatory risk adjustment coding specialist II plays a key role in identifying HCC codes within physician outpatient visits and ensuring they are coded accurately and to the highest specificity. They additionally will verify that documentation requirements are met to validate the HCC diagnosis code. Working closely with the ambulatory clinical documentation specialist (CDS), they will clinically verify the accuracy of HCC codes. Using compliant query guidelines, the coding specialist will query the physician should documentation need clarification or specification. The coding specialist is expected to maintain current knowledge of the ICD-10-CM codes and guidelines and meet minimum productivity requirements outlined by team leadership. What you will do: Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented, resulting in the correct CMS-HCC risk score Responsible for ensuring proper risk adjustment coding Responsible for partnering with ambulatory clinical documentation specialists and physicians to properly code patient charts to ensure appropriate risk adjustment Partners with key stakeholders to advance quality outcomes including, but not limited to, HCC Capture and Risk Adjustment Factor (RAF) Scores Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes Assists the coding team leads with onboarding new coding specialists to the role as needed. Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations Consistently maintain a minimum 95% accuracy on coding quality audits Meet minimum productivity requirements as outlined by the project terms Utilizes technical coding expertise to assign appropriate ICD-10-CM diagnosis codes, as well as assist in appropriate assignment of risk adjustment Maintains advanced knowledge of coding all HCC diagnoses from the medical record in accordance with the ICD-10-CM coding guidelines Assists with and completes special project work as assigned by Ambulatory Clinical Documentation Leadership What you will need: Education: High School Required or Associates Degree Preferred Experience: 2 Years HCC/Risk Adjustment Coding experience or 2 Years Experience in professional coding that includes experiences in physician revenue cycle processes and health information workflows Certification: Certified Risk Adjustment Coder (CRC) - American Academy of Professional Coders (AAPC) required within 6 months of hire Required Benefits: Career Pathways to Promote Professional Growth and Development Various Medical, Dental, and Vision options Tuition Reimbursement Free Parking at designated locations Wellness Program Savings Plan Health Savings Account Options Retirement Options with Company Match Paid Time Off Community Involvement Opportunities Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org. When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential. Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best". Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information. Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all. EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.