Review, analyze, and code diagnoses based on information in a patient's medical record according to specific guidelines for each project
Evaluate compliance with established ICD-10 CM, third party reimbursement policies, regulations and accreditation guidelines
Communicate effectively with internal and external stakeholders according to project requirements
Works with Project Managers to understand client needs and develop project work plans accordingly
Understands Healthcare Compliance concepts, issues, and how to research and access regulatory guidelines and reference materials
Drafts clear and concise analyses of medical record review and coding findings
Ensures successful completion of project deliverables as assigned and within the desired timeframe
Works collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships
Identifies opportunities for cross practice collaboration
Proven writing and presentation skills and has a keen sense of attention to detail
Communicates findings of concern with the team and Project Manager as they are identified
Can independently deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas

Certified in Risk Adjustment Coding (CRC) with at least five (5) recent years of experience in HCC/Risk Adjustment and/or RADV Audit Methodology
Strong understanding of clinical terminology, disease processes, anatomy and pharmacology
Intermediate to advanced understanding of in claims processing procedures, state and federal regulations, and Medicare Part D requirements
Excellent written and verbal communication skills
Ability to work in a remote environment
Time management skills
Prior success in managing small projects and teams
Ability to work on multiple client projects simultaneously if needed
Proficient in Excel, Word, and PowerPoint

Senior Associate, Certified Risk Adjustment Coder

Key skills