Job Description

BroadPath is immediately hiring  Clinical Risk Adjustment   Medical Coders  to join our remote team. Our work at home  Risk Adjustment Medical Coders will be responsible for accurately coding insurance claims into the database system, ensuring compliance with all regulatory requirements and facilitating seamless claims processing.

• Assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses and procedures for insurance claims.
• Accurately enter coded information into the database system to ensure timely and precise claims processing
• Ensure all coding and data entry practices adhere to federal regulations, payer guidelines, and company policies.
• Analyze and review medical records to verify completeness and accuracy of coding information.
• Communicate effectively with healthcare providers to clarify diagnoses and obtain additional information when needed.
• Collaborate with internal departments or vendor to address and resolve any coding-related issues or discrepancies
• Meet all department goals and process workload in a timely and efficient manner by CMS deadlines.
• Supports quality improvement interventions by collecting medical records data
• Data extraction, financial reconciliation, and analytics
• Participate in discussions with respect to ongoing projects
• Production and presentation of results to senior leaders
• Perform ad hoc analysis for multiple product lines
• Multi-tasking, ability to manage at macro level and dig deep into issues for successful resolution.

Must have a valid Medical Coder certification from AHIMA or AAPC:

• Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Based (CCS-P), and Risk Adjustment Coding (RAC).
• Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC), Certified Inpatient Coder (CIC)

Required Qualifications

• Minimum 2-5 years’ experience in  Risk adjustment/HCC coding
• Must be able to identify risk adjustment codes/models.
• Must be a critical thinker.
• Expert knowledge of Medicare severity adjustment processes and tools
• 1+years of experience working with  Risk Adjustment in Medicare Advantage, Medicaid, and/or ACA

Preferred Qualifications

• Recent experience preferred (within last year)
• Experience with multiple vendors and/or health plans preferred

At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!  

Equal Employment Opportunity/Disability/Veterans  

If you need accommodation due to a disability, please email us at HR@Broad-path.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process  

BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.  

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