Upperline HealthUH

Sr. Risk Adjustment Coder

Upperline Health provides comprehensive and compassionate specialty care, aiming to transform the landscape of healthcare for chronic conditions through value-based care.

Upperline Health

Employee count: 201-500

United States only

About Us

Upperline Health launched in 2017 and is a physician practice caring for patients with diabetes and other chronic diseases in value-based care arrangements. We align patients through employed specialists including podiatry, wound care and vascular care. Our team provides an additional layer of support for patients through co-management with the PCP. Upperline's interdisciplinary team sees patients in the clinic, home, hospital and facilities and provides wrap-around services including 24/7 call, remote patient monitoring, behavioral health telemedicine and other resources. Upperline is based out of Nashville, TN.

Benefits

Comprehensive benefit options include medical, dental and vision, 401K and PTO.

About the Risk Adjustment Coder

Upperline Health is seeking a Risk Adjustment Coder who will be responsible for performing pre-visit chart reviews for suspect risk coding, posting visit claims reviews, and ensuring complete capture of patients’ health status. This Risk Adjustment Coder is an integral part of our new value-based care team and will be essential to effectively support our providers and patients. To be successful in this role, this individual will have experience in risk adjustment coding, the prospective risk process with suspecting and comfortable working in EMR systems, preferably Athena. He or she should be a team player who enjoys fast paced environments, rolling their sleeves up to problem solve, and is comfortable adapting the processes and systems to support our physicians in the field and our ACO initiatives. This is the first coder position on Upperline’s new and growing Risk Adjustment team, and we believe this is a unique and exciting opportunity that presents a range of future career growth opportunities within the company.

This position is remote.

What You’ll Do

  • Perform reviews of medical record for complete capture of risk adjustment coding opportunities
  • Follow operational workflows and work to achieve individual and team goals and ensure the highest level of quality, accuracy, and efficiency in delivered to support our providers
  • Conduct post visit claims review to ensure proper documentation
  • Stay up to date on coding and risk adjustment changes
  • Work independently under supervision of risk adjustment leadership
  • Maintain accuracy and productivity goals as set by risk adjustment leadership

Qualifications of the Risk Adjustment Coder

  • 1 + years of risk adjustment coding experience preferred but open to new graduates of coding programs upon completion of coding certification
  • CPC-A, CPC, CRC, RHIT, RHIA or other similar coding credentials from AAPC or AHIMA is required
  • Strong knowledge of risk adjustment coding
  • Understanding of anatomy and physiology and medical terminology and processes
  • Previous experience working with EMR systems - Athena experience highly preferred

About You

  • Team player with respect for others, ability to accept feedback and willingness to learn
  • Thrives in a fast-paced environment, nimble and adaptable to change
  • Excellent communications skills across all levels of team members, providers and leadership
  • Critical thinking skills and attention to detail to review complex patient scenarios in an effective and timely manner
  • Self-motivated and goal oriented and self-motivated to accomplish necessary tasks and achieve successful results

Compensation

Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience

Job Type: Full-time

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Senior

Location requirements

Hiring timezones

United States +/- 0 hours

About Upperline Health

Learn more about Upperline Health and their company culture.

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At Upperline Health, we believe that triage is temporary, but effective treatment is transformative. Founded in 2017, Upperline Health has established itself as the nation’s largest provider dedicated to specialty value-based care. Our mission is to change the landscape of specialty care, providing patients with a more efficient and compassionate journey to health. We deliver consistent and effective treatment for chronic illnesses through a holistic approach that addresses both immediate and long-term health needs.

Our model centers around coordinated care provided by a skilled team of specialists, nurse practitioners, care navigators, nutritionists, and pharmacists. We prioritize making each visit count by going beyond mere referrals; we treat our patients comprehensively. By leveraging our extensive network of 350,000 engaged patients, Upperline Health empowers specialists to focus on overall well-being rather than merely acute needs, promoting long-term health. We aim for our patients to experience seamless care, whether it’s in-office, via telehealth, or at home, ensuring personalized plans that remove barriers to care delivery. Transparency, patient trust, and a commitment to excellence guide our practice. Through our value-based care model, we create significant improvements in patient outcomes, proving that consistent, compassionate healthcare leads to brighter tomorrows for all.

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Upperline Health

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