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Risk Adjustment Coding Analyst

This job is available in 2 locations

Risk Adjustment Coding Analyst

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You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Audit vendor and internal risk adjustments coding to ensure accuracy and identify and mitigate any risks.

* Candidates Must be located in the Las Vegas Metro area.

  • Validate provider, vendor, and internal diagnosis coding for accuracy by reviewing and analyzing samples of coding and claims extract compared to actual medical records
  • Review and identify trends in coding discrepancies and notify applicable department for potential training and education
  • Determine coding issues and discrepancies and make updates as necessary
  • Identify issues, determine impact to risk adjustment models and reports results for various products and services
  • Coordinate delete files with leadership from Medicaid, Medicare, and Marketplace and Encounters department
  • Candidates must be located in the state of Nevada preferably the Las Vegas Metro area.
Education/Experience: High school diploma or equivalent and 2+ years of medical coding, risk adjustment coding or Hierarchical Condition Category (HCC) coding experience in the healthcare industry OR Associate’s degree in health related field and 1+ years of medical coding, risk adjustment coding or Hierarchical Condition Category (HCC) coding experience in the healthcare industry. Experience with various risk adjustment methodology and chart audits.

Licenses/Certifications: CPC, CPC-H, CPC-P, CCS, CCS-P, RHIT, RHIA or CPMA required.Pay Range: $25.44 - $45.76 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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