risk adjustment coding specialist resume example

· Conduct risk adjustment reviews of claims and medical charts of vendors’ diagnoses coding for accuracy

· Perform chart reviews to ensure that ICD-10 codes assigned are supported in clinical documentation

· Participate in RADV audits – review protocols and guidance, coordinate tasks to internal team, point contact person to communicate with vendors and internal team to ensure all tasks are complete by deadlines

· Maintain reports and documentation of RADV audits and compliance oversight activities

· Provide updates on claims and chart review results, RADV audit status

· Identify any diagnoses coding trends for education opportunities

· Write monthly documentation improvement articles of content related to risk adjustment for internal provider newsletter

· Attend calls and webinars with regulatory agencies and vendors

· Developed and maintain tools to support oversight review process and RADV audits

· Maintain knowledge on risk adjustment regulatory news and updates from internet, AHIP, REGTAP, CMS

• Collaborate with internal departments for audits and oversight activities