Risk Adjustment Analyst - NC Licensed

Company: VirtualVocations
Location: Vista
Posted on: May 20, 2025

Job Description:

A company is looking for a Risk Adjustment Analyst- HIM OP CDI.
Key Responsibilities

Analyze and audit medical records for payer audits under Value Care contracts
Review HCC Edit WQ cases to reorder diagnoses for claim billing
Conduct pre-visit medical record reviews to ensure accurate documentation of HCC conditions

Required Qualifications

High school diploma or GED required
Successful completion of the OP CDI Proficiency Test
Certification from AHIMA, AAPC, ACDIS, or relevant nursing licenses required
Minimum of twelve months of OP coding or nursing experience in an ambulatory care setting
Strong knowledge of medical record documentation and coding guidelines

Keywords: VirtualVocations, Tustin , Risk Adjustment Analyst - NC Licensed, Professions , Vista, California

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