Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment

As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will:

• Conduct medical record audits for physicians (MD, DO, or NP) to ensure documentation and coding accuracy of ICD-10 CM codes related to chronic conditions
• Analyze coding patterns within medical groups.
• Provide customized education and updating educational materials for providers and medical groups.
• Participate in additional audit activities for CMS RADV as needed, including retrospective chart reviews.
• Travel to provider offices within Los Angeles area at least three days a week.

Note: This posted position is 1 of 2 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.