Senior BPM Associate (HCC Risk Adjustment Coder)

• Assign appropriate ICD-10-CM codes, mapping to risk adjustment models for Medicare Advantage and ACA Commercial Projects.
• Assign Flag events and CDI for documentation discrepancies.
• Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines
• Comply with HIPAA laws and regulations
• Maintain quality (=>97%) and production standards
• Remain up to date on diagnosis, coding guidelines and risk adjustment reimbursement reporting requirements
• Other tasks as needed/required

• Medical allied course an advantage and Risk Adjustment experience can be considered in lieu of educational requirement
• Medical coding experience an advantage
• Active coding certification under AAPC or AHIMA or Certified Risk Adjustment Coding Certification (CRC)
• Able to code using ICD-10 CM physical codebook or coding software
• Strong clinical knowledge related to chronic illness diagnosis, treatment and management
• Computer proficiency (MS Office and internet)
• Amenable to nightshift

UST