VMG Risk Adjustment Coder - CRC within 6 months! (Remote) at Virta Health

Hundred, West Virginia, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

CPC certification required
CRC certification required or must be obtained within 6 months of hire
Minimum of two years records coding experience or equivalent
HCC experience strongly preferred
Ability to perform functions in a Microsoft Windows environment
Ability to be detail oriented and perform tasks at a high level of accuracy
Ability to make sound decisions
Demonstrate good communication and teamwork skills
Previous experience with an electronic health record system
Understand the anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses

Responsibilities

Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for risk adjustment models (e.g., HCCs, CDPS, HHS risk adjustment)
Identifies and communicates coding deficiencies to clinicians to improve documentation for accurate risk adjustment coding
Provides ongoing training and education to clinicians and physicians during 1:1, physician group, performance improvement, and ad hoc meetings
Manages and trends data collection for HCC and other risk coding
Performs data mining from data captured through risk adjustment coding
Works with Manager and Director of VMG Quality Department to strategize and prioritize chart reviews and education
Assists with the development of action plans to improve documentation
Completes chart reviews for various Values Based Programs focusing on annual review of suspect chronic conditions; utilizes payer portals as necessary to complete annual coding reviews

Skills

Key technologies and capabilities for this role

CPCCRCHCCRisk Adjustment CodingMedical Coding

Questions & Answers

Common questions about this position

Is this position fully remote?

Yes, the position is 100% remote, but Virtua welcomes candidates only from specific states: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV. Local candidates are preferred due to occasional onsite requirements.

What certifications are required for this role?

CPC certification is required, and CRC certification is required or must be obtained within 6 months of hire. HCC experience is strongly preferred.

What is the salary for this VMG Risk Adjustment Coder position?

This information is not specified in the job description.

What are the main responsibilities of this role?

The role involves evaluating and analyzing medical records for proper documentation and correct ICD-10-CM codes for risk adjustment models like HCCs, communicating coding deficiencies to clinicians, and providing ongoing training to clinicians and physicians.

What makes a strong candidate for this position?

Strong candidates will have CPC certification, the ability to obtain CRC within 6 months, HCC experience, and preference for local candidates due to occasional onsite needs.

Virta Health

Reverses type 2 diabetes through personalized care

About Virta Health

Virta Health focuses on reversing type 2 diabetes through a combination of personalized nutrition, continuous remote care, and behavioral science. Their treatment is designed for individuals diagnosed with type 2 diabetes, healthcare providers, and enterprise partners like employers and health plans. Unlike many competitors, Virta Health operates on a performance-based model, meaning they only receive payment if they achieve successful outcomes for their patients. This aligns their financial incentives with patient health improvements. The company's goal is to reverse type 2 diabetes in 100 million people, making their approach not just about managing diabetes but actively working towards its reversal.

Denver, ColoradoHeadquarters

2014Year Founded

$362.8MTotal Funding

SERIES_ECompany Stage

Biotechnology, HealthcareIndustries

501-1,000Employees

Benefits

Remote-first work environment

Flexible work hours & time off policy

Health insurance

Paid parental leave

Free Virta treatment & family discount

Internet, home office, learning & development stipends

Employee resource groups

401K & ROTH contribution

Risks

Increased competition in diabetes reversal could threaten Virta's market share.

Rising popularity of GLP-1 medications may divert clients from Virta's approach.

Regulatory changes in GLP-1 prescriptions could impact Virta's business model.

Differentiation

Virta Health offers a medication-free approach to reversing type 2 diabetes.

Their performance-based model aligns financial incentives with patient outcomes.

Virta's continuous remote care platform provides personalized nutrition and behavioral support.

Upsides

Virta Health has achieved over $100M in annualized revenue with sustainable weight loss solutions.

Partnerships with major payers like U-Haul enhance Virta's market reach and credibility.

Growing skepticism about GLP-1 medications boosts demand for Virta's alternative treatments.

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