Location
Denver, CO | United States
Job description
Full job description
What We Strive For
Strive Health is built for purpose — to transform a broken kidney care system. We are fundamentally changing the lives of people with kidney disease through early identification, engagement and comprehensive coordinated care. Strive's model is driven by a high-touch care team that integrates with local providers and spans the entire care journey from chronic kidney disease through end-stage kidney disease, leveraging comparative and predictive data and analytics to identify at-risk patients. Strive Health's interventions significantly reduce the rate of emergent dialysis crash, cut inpatient utilization and significantly improve patient outcomes and experience. Come join our journey as we create THE destination for top talent in the healthcare community and set a new standard for how kidney care should be done.
Why We're Worth the Application
- We Strive for excellence and Strive has been recognized with six Best Place to Work awards, including Forbes America's Best Startup Employers 2023 and 2022, Built In Colorado's Best Places to Work 2022 and 2024, Comparably's Best Places to Work in Denver 2022 and The Tech Tribune's Best Startups in Denver 2022. Additionally, Strive's CEO, Chris Riopelle, has been recognized as one of Denver Business Journal's Most Admired CEOs.
- We derive innovation and ideas from through authentic diversity intentionally building a team that represents the populations we serve in partnership with our Employee Resource Groups:
- Strive Forward - LGBTQ
- Underrepresented Minorities
- Women and Allies
- We care and support our Strivers within and beyond work to feel fully charged and empowered through our generous wellbeing offerings including:
- Flexible time off
- Companywide wellbeing days
- Volunteer time off
- Leave packages including a sabbatical, parental leave and eight weeks paid for living donor
- Professional development
- A dedicated certified financial planner
- Headspace, Carrot Fertility and Gympass for all Strivers
- We like to have fun by celebrating our successes as a team through team building, company gatherings, trivia, wellbeing raffles, pajama days, a companywide book club and more.
- We value tenacity to help us overcome obstacles with grit and determination to deliver compassionate kidney care.
Risk Adjustment Coding Analyst
The Risk Adjustment Coding Analyst is responsible for supporting the Strive clinical team and partner Nephrologists by providing risk adjustment education and clinical documentation support. The Risk Adjustment Coding Analyst is responsible for supporting the growth and improvement of Strive's risk adjustment capabilities by conducting training, education, and management of coding and documentation improvement program. The Risk Adjustment Coding Analyst ensures technical aspects of diagnostic and procedure coding follow CMS, NCQA, third party payers and other regulatory agencies. They will monitor assigned provider's documentation and coding, educate assigned providers on CMS, AMA and Strive documentation and coding guidelines, educate assigned ongoing education of ICD-10-CM to the providers and Perform provider queries and addendum requests based on CMA, AMA documentation and coding guidelines The Risk Adjustment Coding Analyst will provide ongoing feedback and education to the clinical management team regarding accurate documentation to improve overall health outcomes for patients and continuity of care.
Essential Functions
- Delivers value to Strive and its beneficiaries enrolled in Risk Adjusted government programs (MA, ACO, ACA, CKCC), using skills including but not limited to: HCC (Hierarchical Condition Category) Coding, medical coding, clinical terminology and anatomy/physiology, CMS coding guidelines, and RADV Audits
- Works closely with physicians, team members, quality, and compliance partners at enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding
- Supports all Strive risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories
- Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements
- Perform HCC coding on projects for MA, ACA, and ESRD. Ability to quickly flex between coding projects, including retro and prospective, with different MA, ESRD, and ACA HCC Models
- Ability to work independently in various coding applications and electronic medical record systems to support departmental goals
- Adheres to CMS Guidelines for Coding and Strive's Policy and Procedures to guide HCC coding decision making
- Assist with regulatory audits by performing first coding review and ranking of charts
- Build partnerships and work within coding teams and internal partners critical to HCC coding including RCM
- Participate on ad-hoc projects per the direction of leadership to address the needs of the department
- Provide recommendations for process improvements and efficiencies
- This individual will work in a matrixed organization to deliver complex ideas, support various key stakeholders, and assist with executing new risk adjustment initiatives
- Using primarily the HCC Risk Adjustment model, conduct training with individual and large provider groups
- Educate providers on the purpose of risk adjustment, as well as detailed and current risk adjustment documentation and coding training
- Execute on risk adjustment onboarding training plans with new providers in the market
- Analyze key coding performance indicators to determine those providers in need of initial or additional training
- Identify training priorities and proactively schedule provider trainings with provider's offices, individual providers, and groups of providers
Minimum Qualifications
- Active, CPC and CRC (Certified Risk Adjustment Coder) License
- 2+ years of experience in out-patient risk adjustment coding, documentation, reporting, and auditing in a healthcare or managed care environment
Preferred Qualifications
- The ideal candidate is an expert in coding and documentation guidelines, knows how to develop strong relationships with clinicians, and is an effective, strong communicator
- Use a customer focused approach in dealing with conflict and resolution of problems
- Successful candidates will also have extensive presentation experience in the following areas: ICD-10-CM, CPT and HCPCS
- Five years' experience using ICD-10-CM, two years' experience with risk adjustment training geared toward physicians
- Extensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes
- Expert knowledge of Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance
- MS Office Suite, Electronic Medical Records, Encoder, other software programs and internet-based applications as
- Strong clinical assessment and critical thinking skills
- Excellent verbal and written communication skills
- Ability to work in a team environment.
- Flexibility and strong organizational skills needed
Annual Salary Range: $66,000.00-$77,000.00
Strive Health offers competitive compensation and benefits, including Health insurance, Dental insurance, Vision insurance, 401k Retirement Plan with Employer Match, Life and Accidental Death & Dismemberment insurance, Disability insurance, Health Savings Account, Flexible Spending Account, paid company holidays, in addition to Vacation Time Off. An annual performance bonus, determined by company and individual performance, is available for many roles as aligned to Strive Health guidelines.
Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected]
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