Working Each Day to Make a Difference

At Community Health Plan of Washington, we're driven by our belief that everyone deserves access to quality health care.

More than 25 years ago, we made a commitment to improve the health of our communities by making quality health care accessible to all Washington state residents.

We continue that pledge today by providing affordable comprehensive coverage to more than 315,000 individuals and families throughout the state.

• We are a local not-for-profit health plan in Washington State.
• We are committed to keeping Washington families healthy.
• We connect our communities to the health resources they need.
• We provide access to high-quality care for our members.
• We connect and empower our members through technology.
• The Community Health Centers we partner with strive to support members with a comprehensive mix of medical resources in one convenient location.
• Our partnerships with Community Health Centers and our extended provider network help us improve the health care delivery system.

To learn more about how you can make a difference working at Community Health Plan of Washington, visitwww.chpw.org{rel="nofollow"}.

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*Risk Adjustment Coder -- Hybrid, WA *

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[POSITION PURPOSE:]{.underline}

As a Risk Adjustment Coder for Community Health Plan of Washington, you will be responsible for ensuring accurate and timely coding of medical records to support risk adjustment activities.  Work scope includes coding medical charts, supporting chart audits, and reviewing output from coding vendors.

[PRINCIPAL DUTIES:]{.underline}

• Review, analyze, and audit medical records, encounter forms, and other documentation to accurately validate and assign ICD-10-CM, and other relevant codes for risk adjustment coding & audit purposes.
• Ensure all claims are coded accurately, completely, and in compliance with all regulatory requirements and health plan policies.
• Provide verbal and written reporting on weekly coding audit results and trends to risk adjustment team coding leadership using defined templates, emails, and meetings.
• Collaborate with health plan staff, risk adjustment team members, and other stakeholders to resolve coding-related issues and concerns.
• Support coding processes and procedures to ensure compliance with coding guidelines and regulations.
• Participate in cross-functional teams to support health plan initiatives related to coding and risk adjustment submissions.
• Maintain 95% coding accuracy rate, and minimum charts per hour performance (as defined with manager).
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

[QUALIFICATIONS:]{.underline}

[Education &]{.underline} [Prior Related Experience]{.underline}:

Have a minimum of 2-3 years of experience in risk adjustment coding, preferably in a health plan setting.

Have a minimum of 2-3 years of experience with Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Categories (HCCs) and/or HHS-HCC models.

Are an American Health Information Management (AHIMA) Certified Coding Specialist (CCS) or American Academy of Professional Coder (AAPC), Certified Professional Coder (CPC) or Certified Professional Coder -- Hospital (CPC-H) Coding Certification.

Are a certified Risk Adjusted Coder (CRC).

Proficiency in Microsoft Office applications such as Outlook, Excel, Word, and Power Point.

Have experience with experience with Medicaid Chronic Illness and Disability