Adjustment Clerk jobs in San Jose, CA

Fathom is on a mission to use AI to understand and structure the world’s medical data, starting by making sense of the terabytes of clinician notes contained within the electronic health records of the world’s largest health systems. Our deep learning engine automates the translation of patient records into the billing codes used for healthcare provider reimbursement, a process today that costs hospitals in the US $15B annually and tens of billions more in errors and denied claims. We are a venture-backed company that completed a Series B round of financing for $46M in late 2022.

We are seeking a Risk Adjustment Coding Advisor to contribute to Fathom’s next stage of growth. This role is an excellent opportunity for a talented, entrepreneurial strategist and operator to bring a consulting toolkit, a working knowledge of medical coding or revenue cycle management, and a drive to transform healthcare to a high-growth technology firm. This is a cross-functional role working across disciplines including product, sales, finance, operations, and engineering. If this opportunity speaks to you, we want to hear from you!

Please note that this position requires physical residency in the U.S.

Your role and responsibilities:

• Working with clients to establish and maintain risk adjustment coding accuracy thresholds
• Reviewing and auditing medical records and physician documentation for HCC accuracy
• Conducting strategic analysis and scenario modeling across functional disciplines
• Tracking, aggregating and summarizing coding and billing rules for the product team
• Collaborating with engineering, product, and customer success teams on client roadmap
• Providing coding education and training to internal engineering and product teams
• Preparing executive presentations and reports for internal and external audiences
• Developing and enhancing internal and client-facing analytics and reporting

We are looking for a teammate with:

• Current AAPC CRC certification or AHIMA RAC microcredential
• Prior experience working in healthcare, especially healthcare consulting
• Experience working with and developing HCC medical coding guidelines, documentation requirements, and audit programs
• Working knowledge of anatomy/physiology, disease process and medical terminology
• Familiarity with medications and reimbursement guidelines 
• A proven ability to communicate effectively across domains and experience levels
• Drive to innovate, identify novel approaches, and act decisively
• Fluency in productivity tools like Microsoft (Excel, Powerpoint) and Google Suite (Sheets, Docs, etc.)

Bonus points if you have the following experiences:

• Coding compliance consulting and/or coding litigation consulting
• Revenue cycle management
• External vendor management
• Clinical documentation improvement
• Prior work in an entrepreneurial environment
• Prior work in client-facing and/or project management roles
• Additional AHIMA or AAPC certifications

Salary range:

• $100 000 - $160 000 USD