Certified Coder-Risk Adjustment

Meritas Health is hiring a Certified Coder-Risk Adjustment to join our Coding & Denial team!  If you’re looking for a great opportunity to serve our community and be part of a growing organization, join our Meritas team!

Here at Meritas our mission is to provide hope and healing to every life we touch.  Whether you are serving patients at a primary care practice, specialty practice, or in a support capacity, every team member works together to complete this mission. 

Why Meritas?

• Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)
• Employer matched retirement plan
• Competitive wages
• Paid time off for personal/vacation/sick
• Six paid holidays per year
• Educational assistance
• Day shift schedules

What does a Certified Coder-Risk Adjustment do?

Under the direction of management, this position works in a collaborative effort directly with providers to review medical records and other clinical documentation to identify appropropriate risk adjustment codes and quality gap closure opportunities.  The Coder - Risk Adjustment is responsible for reviewing procedures and diagnosis codes for accuracy and/or assigning proper code based upon provider documentation.

What does a typical day on the job look like?

• Coordinates and collaborates with clinic leadership to assist in identification of clinical best practices to ensure all diagnoses are captured in accordance with CMS Risk Adjustment coding guidelines.
• Reviews procedures, HCPCS, and diagnosis coding for accuracy and/or assigns proper codes based upon medical record documentation.   Reviews documentation for capture of additional  hierarchical condition category (HCC) by physician wording in EMR that suggests an HCC diagnosis; problem list/medical history in EMR that suggest an HCC diagnosis; reports provided from payers and accountable care organization (ACO). Posts charges accurately and timely. Maintains problem lists in EMR with claims data.
• Works cooperatively with the Denials Team and Central Billing Office to resolve claims denials and billing issues.
• Abstracts all risk adjusted diagnosis codes from acceptable provider documentation and in accordance with industry standards for coding and reporting.  Conducts provider queries for any documentation inconsistencies within EMR and/or other query system.
• Acts as a resource to assigned provider and other clinic staff for questions related to procedural coding and to ensure coding accuracy and the capture of all HCCs to their highest specificity. 

What are the requirements for the job?

• High school graduate or GED equivalent
• 3-5 years experience in medical billing and insurance.
• Certification of a Procedural Coding/Insurance Program (CPC). Certified Risk Adjustment Coder (CRC) preferred.
• Knowledge of CPT4, ICD-9  and ICD-10 coding and medical terminology.
• Basic office skills with strong attention to detail and high degree of accuracy.  Ability to assimilate and adapt quickly and accurately to coding guidelines and/or other workflow and job-related changes.

More Possibilities:

As the largest network of providers in the Northland, we can offer you more opportunities to grow. Here at Meritas, we believe that together, we will become legendary for our commitment to remarkable patient care.

Meritas Health is an Equal Opportunity Employer and values diversity in our organization. We do not discriminate against any applicant for employment or employee on the basis of race, color, religion, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws.