Clinical Analyst - Registered Nurse, Certified Professional Coder (CPC)

Clinical Analyst - Registered Nurse - HYBRID
We are seeking a detail-oriented and analytical Clinical Analyst to join our healthcare team. The ideal candidate will be responsible for managing and analyzing clinical data to support decision-making processes within the organization. The Clinical Analyst will work closely with healthcare professionals to enhance data management practices and improve patient outcomes.

Schedule: Hybrid - 3 days in the office & 2 work from home.

Responsibilities

• Analyze clinical data to identify trends, patterns, and insights that support operational improvements.
• Report to the Risk Adjustment Manger in Government Markets.
• Analyzing clinical charts, diagnosis data, CPT Codes.
• Chart coding reviews and recommend solutions to improve quality
• Recommend solutions that physicians and staff can use
• Provide training and support to staff on the use of risk adjustment coding policies

QUALIFICATIONS

• RN license
• CPC (Certified Coding Professional) credential required
• CRC (Certified Risk Adjustment Coder) credential required. Required to obtain CRC within one year of hire
• Minimum 3+ years’ experience in risk adjustment coding activities in a Medicare/ACA or provider organization to include RAPS, EDPS, RADV Audits and all CMS/HHS, and other regulatory Guideline required.
• Expert knowledge of risk adjustment, Hierarchical Condition Category (HCC), medical terminology and medical chart review required.
• Experience in coding guideline and policy implementation
• Knowledge of ICD-9 / ICD-10 diagnosis and procedure codes, CPT codes, Revenue codes, and HCPCS codes

Compensation:

78,000-95,000 (depending on years of experience) plus excellent benefits.

Join our team as a Clinical Analyst where your expertise will contribute significantly to improving healthcare delivery through effective data management and analysis.

Please send resume to Donna Ellixson or call 610-684-4742