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AdventHealth Risk Adjustment Coding Specialist - CPC in Maitland, Florida


Risk Adjustment Coding Specialist - PHSO | AdventHealth Corporate

Location Address: 485 N Keller Rd, Maitland, FL 32751

Top Reasons to Work at AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential

Work Hours/Shift:

  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Review and assess documentation and accurately translates chronic conditions into the appropriate diagnosis code from inpatient and outpatient medical records
  • Extracts data for Health Plan reports
  • Inputs data collected from HCC programs
  • Coordinates audits of Provider coding data
  • Responsible for scheduling of audits
  • Sends Provider the list for chart reviews and provides follow-up communication
  • Assists in obtaining medical records from Providers to support audits requested by Health Plans
  • Assists in coordinating Physician and staff training sessions


What You Will Need:

Education and Experience Required :

  • Minimum of three years of healthcare experience
  • Minimum of 3 years’ experience in HCC coding

    Education and Experience Preferred:

  • Prior risk adjustment and medical record review experience

  • Strong ambulatory background with a focus on diagnostic coding
  • Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing and various healthcare payers

    Licensure, Certification, or Registration Required:

  • CPC (Certified Professional Coder)

    Knowledge and Skills Required :

  • High level of interpersonal and communication skills necessary to establish rapport with physicians and other healthcare providers.

  • Basic MS Office (Word, Outlook, Excel and PowerPoint) knowledge
  • Ability to perform the following: Faxing, scanning, record storage, archiving records for storage

Job Summary:

The Medicare Risk Adjustment Coding Specialist coordinates and supports retrospective and concurrent chart reviews in addition to education and chart retrieval for Health Plan audits and reports. Uses knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Physician Services

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Travel: No

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.