MEDICAL CODING SPECIALIST-RISK ADJUSTMENT

MAKE A DIFFERENCE AT OCHIN

OCHIN is a nonprofit leader in health care innovation and a trusted partner to a growing national provider network, delivering the clinical insights and tailored technologies needed to expand patient access, strengthen care teams, and improve the health of rural and medically underserved communities.

We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our vision of good health and well-being for everyone.

At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture rooted in our values.

Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 1,200 skilled professionals, working remotely across 49 states. We offer a generous compensation package and are committed to supporting our employees’ entire well-being by fostering a healthy work-life balance and opportunity for professional advancement. We are curious, collaborative learners who strive to live our values every day. OCHIN is excited to support our continued national expansion and the increasing

demand for our innovative tools and services by welcoming new talent to our growing team.

Work Authorization

Candidates must be legally authorized to work in the United States on a permanent basis at the time of application.

This position is not eligible for employment visa sponsorship now or in the future. OCHIN does not provide sponsorship for employment-based visas or transfers of existing employment-based visas.

Position Overview:

The Outpatient Coding Specialist plays a critical role in delivering accurate and high-quality healthcare coding services to OCHIN member clinics and acute care hospital organizations. This position is responsible for identifying potential high-risk coding trends, applying best practices to optimize revenue, and enhancing coding accuracy to support a streamlined and efficient revenue cycle.

The Coding Specialist proactively escalates complex or unique coding issues, collaborates with supervisors to resolve challenges, and applies newly acquired knowledge to future scenarios. Additionally, this role contributes to continuous improvement efforts by recommending process enhancements that increase operational efficiency and effectiveness.

Essential Functions:

• Accurate and Compliant Coding: Deliver efficient and accurate coding services on behalf of member clients, ensuring full compliance with payer requirements, organizational policies, and all applicable coding guidelines.
• Clinical Data Abstraction: Extract and interpret relevant clinical data—including diagnoses and procedures—from patient medical records and electronic health systems to support accurate code assignment.
• Code Assignment and Validation: Review and analyze patient encounters to assign appropriate diagnosis and procedure codes, ensuring accuracy and completeness for all relevant clinical information.
• Reimbursement Optimization: Support member organizations in achieving appropriate reimbursement by reviewing and recommending accurate code assignments that are critical to third-party payer claims.
• Provider Communication and Documentation Follow-Up: Conduct research and obtain additional information from providers or clinical staff via Epic In-Basket messaging, as needed and in accordance with established agreements. Messaging, as needed and in accordance with established agreements.
• Other duties as assigned.