Anthem, Inc. Mgr Medicare Risk Adj & Coding in Reston, Virginia
SHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.
Location: Remote Based – open to candidates in either NY, CT, VA, ME, GA, or NJ
The Mgr Medicare Risk Adj & Coding is responsible for managing a team of coders in the identification, collection and assessment of claim/encounter information as it pertains to CMS guidelines to ensure for coding accuracy. Responsible for risk adjustment operations, provider education, and data analysis.
Primary duties may include, but are not limited to:
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Communicates and presents coding accuracy results to internal and external customers.
Manages the performance of the various prospective and retrospective programs deployed throughout the region
Educates multilayered provider groups on risk adjustment documentation.
Ensures compliance with CMS mandated and corporate policies
Analyzes risk adjustment trends to identify strategies for coding accuracy
Ensures compliance with mandated corporate policies.
Requires CPC, CPC-H, CCS, or CCS-P and minimum of 2 years’ experience in healthcare industry; or any combination of education and experience, which would provide an equivalent background.
Requires AAPC or AHIMA coding certification.
Travel may be required.
5-6 years’ experience in healthcare industry and expertise in Medicare Risk Adjustment; or any combination of education and experience, which would provide an equivalent background.
BA/BS in Health Care or Business preferred.
RN, LPN, or foreign physician preferred.
Provider engagement is a plus
Value base contracting knowledge is a plus.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact email@example.com for assistance.