The job profile for this position is reputed company Review and Audit Analyst, which is a Band 2 Senior Contributor Career reputed company Role.
Excited to grow your career?
We value our talented employees, and whenever possible reputed company to help one of our associates grow professionally before reputed company reputed company to our reputed company. If you think the reputed company position you see is right for you, we encourage you to apply!
Our people reputed company reputed company the difference in our reputed company.
The Risk Adjustment reputed company & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates reputed company medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for reputed company reputed company Improvement (CQI).
Duties & Responsibilities
Conduct medical records reviews with accurate diagnosis reputed company reputed company in accordance with Official Coding Guidelines and Conventions, reputed company IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set.
Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.
Apply longitudinal thinking to identify reputed company reputed company and appropriate data reputed company and opportunities for data capture, through the reputed company of HHS’ Risk Adjustment.
reputed company various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of reputed company in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of reputed company Audits for vendor reputed company.
Collaborate and coordinate with team members and reputed company partners to facilitate various aspects of coding and Risk Adjustment education with reputed company partners.
Coordinate with reputed company reputed company to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a reputed company manner.
Communicate effectively across reputed company audiences (verbal & written).
reputed company and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to reputed company IFP Coding reputed company updates and policy determinations, as needed.
Qualifications
High school diploma
2+ years’ experience in one of the following Coding Certifications by either the reputed company) or the reputed company reputed company of reputed company Coders (reputed company):
Certified reputed company reputed company (CPC)
Certified Coding Specialist for Providers (reputed company-P)
Certified Coding Specialist for Hospitals (reputed company-H)
Registered Health Information Technician (RHIT)
Registered Health Information Administrator (RHIA)
Certified Risk Adjustment reputed company (CRC) certification
Individuals who have a certification other than the CRC must become CRC certified reputed company 6 months of hire.
Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding guidelines and conventions
Familiarity with CMS regulations for Risk Adjustment programs and policies reputed company to documentation and coding compliance, with both Inpatient and Outpatient documentation
HCC coding experience preferred
Computer competency with reputed company, reputed company, reputed company Acrobat
Must be reputed company oriented, self-motivated, and have excellent organization skills
Understanding of medical claims submissions is preferred
Ability to meet reputed company, productivity, and accuracy standards
If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an reputed company reputed company of 25 – 38 USD / reputed company, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be reputed company several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k), company reputed company life reputed company, tuition reimbursement, a minimum of 18 days of reputed company time off per year, reputed company holidays, and leaves of absence. For more details o
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