About the job
About IntusCare
IntusCare is a pioneering end-to-end ecosystem designed exclusively for Programs of All-Inclusive Care for the Elderly (PACE). Our mission is to enhance care delivery, improve financial performance, and ensure compliance. By replacing outdated technology with innovative solutions tailored for care coordination, risk adjustment, population health, and utilization management, IntusCare empowers teams to optimize their operations and deliver better outcomes for dual-eligible seniors—some of the most vulnerable and clinically complex individuals in the U.S. healthcare landscape.
Role Overview
As a Risk Adjustment Consultant, you will be integral to the success of PACE programs by guaranteeing precise diagnosis capture, compliant documentation, and enhanced revenue integrity. Collaborating closely with the IRIS team, clinical staff, project managers, and client leadership, you will provide high-quality coding services, educational support, and operational guidance in risk adjustment. This role is perfect for coding professionals who thrive on the blend of technical precision and client-facing education, with a focus on workflow enhancement and collaborative problem-solving.
Key Responsibilities:
Risk Adjustment Operations
Perform thorough and precise medical record reviews adhering to ICD-10-CM Official Guidelines, AHA Coding Clinic, and internal IRIS Coding Guidelines.
Execute Pre-Encounter Preparation (PEP) and concurrent coding workflows with exceptional accuracy and efficiency.
Analyze analytics dashboards to pinpoint documentation and coding discrepancies, emerging trends, and areas for improvement.
Guarantee adherence to CMS risk adjustment guidelines, Hierarchical Condition Category (HCC) frameworks, and RADV audit standards.
Achieve a coding accuracy score of 95% or higher through diligent quality maintenance and adherence to established guidelines.
Client Engagement & Documentation Enhancement
Act as the primary liaison for assigned PACE clients, delivering continuous risk adjustment guidance and support.
Collaborate with providers to elevate the quality, accuracy, and completeness of documentation.
Implement structured feedback mechanisms, individualized coaching, and ongoing documentation improvement strategies.

