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Coder - Risk Adjustment at Prominence Health Plan in Reno, Nevada

Posted in Other 30+ days ago.

Type: Full Time

Job Description:

Job Summary:

The Coder of Risk Adjustment will be responsible for accurate coding and documentation which is imperative to support proper reimbursement from Medicare while ensuring organizational compliance. The Coder will perform production coding and coding auditing as well as medical record abstraction in support of the Healthcare Effectiveness Data and Information Set (HEDIS) data collection. The ideal candidate will be well grounded in sound medical coding practices, with experience working in the CMS Medicare Advantage and/or HHS Commercial risk adjustment model. Knowledge of HEDIS data collection is required.

Job Requirements


High school education or GED. Associate's degree preferred.

Coding certification (CCS or CPC through AHIMA/AAPC)

ICD-10 coding proficiency

3-5 years experience in CMS HCC risk adjustment coding

2+ years experience in a managed care setting

RHIT and CRC certification preferred.


* Ability to effectively communicate in English, both verbally and in writing.


Proficient in Microsoft Office Suite Word, Excel and Access

Excellent written and oral communication skills

Attention to the detail.

Billing experience is a plus.

Comfortable working in a department with set productivity and coding accuracy standards

Experience with NCQA HEDIS programs preferred.

Experience working in health care and health insurance industry. Knowledge of HEDIS data collection is preferred.

All employment at UHS is with one of the subsidiaries of Universal Health Services, Inc., including its management company, UHS of Delaware, Inc. Universal Health Services is a holding company.

UHS is an Equal Opportunity Employer and as such, openly supports and fully commits to recruitment, selection, placement, promotion and compensation of all individuals without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status or any other characteristic protected by federal, state or local laws.