Risk Adj & Coding Ld

Description

Your Talent. Our Vision.  At CareMore, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination.  It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.

CareMore is a proven care delivery model for the highest-risk.  We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.  We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients.  We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience.  As an Anthem subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations.

*Position will be working remotely And occasionally out of either the Sacramento, CA, and/or Modesto, CA medical office(s).

The Risk Adj & Coding Ld is responsible for leading a team of coders in the identification, collection and assessment of claim/encounter information as it pertains to CMS guidelines.

Primary duties may include but are not limited to:

• Conducts retrospective and prospective medical reviews to assess accuracy of documentation and coding.
• Performs ongoing review, monitoring and communication of medical record review to assigned providers.
• Provides individual and group education to ensure ongoing accuracy of documentation and submitted Risk Adjustment diagnosis codes.
• Oversees day to day operations.
• Ensures compliance with mandated and corporate policies.

Qualifications

Minimum Requirements:

• Requires BA/BS in health care or business and minimum of 2 years’ experience in healthcare industry and expertise in Risk Adjustment; or any combination of education and experience, which would provide an equivalent background.
• AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association) coding certification or equivalent certification is required.
• Travel may be required.

Preferred Qualifications:

• Risk Adjustment Coding certification highly preferred.
• Clinical Documentation Improvement Specialist certification highly preferred.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.