Risk Adjustment Consultant

We are currently seeking a Risk Adjustment Consultant to join our team on a full-time basis. The Risk Adjustment Consultant is responsible for providing consulting services to clients to include: implementing HCC recapture services, establishing best practices for accurate and complete HCC documentation and coding, and providing training on HCC documentation requirements for providers and/or HCC coders. Additional responsibilities include:

  • Communicate with clients, provide client support, and conduct client conference calls as needed.
  • Evaluate and document client processes and identify process improvement opportunities to assist clients with accurate HCC documentation and reporting for appropriate risk adjustment payment
  • Implement leading practices for HCC recapture within clients’ ambulatory clinic workflow to ensure client-specific goals are achieved.
  • Develop or assist in preparation of client deliverables that contain findings, observations, and recommendations for improvement.
  • Prepare and deliver training on HCC documentation requirements, customized to the client audience (e.g., providers, HCC coders) and to reflect the client’s documentation samples
  • Review patient charts to identify documentation or coding gaps impacting RAF scores.
  • Review charts to assure clinical documentation supports MEAT requirements and identify trends in documentation gaps identified.

Position requirements include:

  • 3 years of experience in an ambulatory clinic setting, with knowledge of ICD-10-CM and CPT/HCPCS coding requirements
  • AHIMA or AAPC certification 
  • Demonstrated expertise in Risk Adjusted payment methodologies and HCC reporting requirements
  • Previous experience working in a consulting environment preferred
  • Excellent verbal and written communication skills including the ability to communicate to clients with confidence on site and via webinar/conference calls
  • Technical skills with a variety of EMR systems in order to navigate various client systems efficiently. 
  • Technical skills including the ability to utilize dual monitors, virtual machine and remote desktop