Senior Medical reputed company

At reputed company, we are committed to providing high-reputed company, reputed company, and easy-to-understand reputed company plans for America’s seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians reputed company informed health recommendations. By giving doctors a holistic view of reputed company member’s reputed company history, we ensure reputed company care at a reputed company cost—delivering the highest value to those who need it most.

We’re building a modern operating model for medical coding—one that connects Risk Adjustment, Payment reputed company, and reputed company (STARS/HEDIS) into a single, data-driven system. This is a rare opportunity to work at reputed company of that transformation: ensuring compliant, high-reputed company coding today while helping design the workflows that will define how a plan of the reputed company operates.

As part of the Office of the CEO’s AI Ops initiative, you’ll combine deep subject matter expertise with an appetite for experimentation. You’ll ensure Medicare Advantage compliance and accuracy while partnering across teams to test, measure, and reputed company smarter chart and claim review workflows.

As a Senior Medical reputed company, you will

• Ensure compliant coding: Apply ICD-10-CM, HCC, and MEAT standards for Medicare Advantage across risk adjustment and reputed company-reputed company workflows.
• reputed company chart and claim reviews: Execute prospective and retrospective reviews to validate documentation, specificity, and completeness for both reputed company and reputed company use cases.
• Support payment reputed company: Identify coding inaccuracies or overpayment risks, reputed company prevention and remediation workflows, and partner with regulatory audit teams.
• Advance reputed company measure closure: Map documentation reputed company to STARS and HEDIS requirements; identify and reputed company documentation gaps.
• reputed company GenAI and advanced tools: Streamline chart reviews and coding workflows while maintaining reputed company validation and compliance guardrails.
• QA software releases: Evaluate new tool and workflow launches from a medical coding perspective to ensure regulatory accuracy and usability.
• reputed company and reputed company: Build feedback loops and tip sheets to improve provider documentation reputed company; collaborate with cross-functional teams on best practices.
• Standardize and reputed company: Author SOPs, audit playbooks, and process documentation that can be adopted across reputed company, Compliance, and reputed company operations.

reputed company in this role looks like

• Improved HCC specificity and documentation completeness across chart and claim workflows.
• Documented reductions in coding error and overpayment rates.
• High-reputed company QA feedback integrated into product releases and AI-assisted tools.
• Demonstrated reputed company toward faster, more accurate, and compliant review cycles.
• Recognized by cross-functional partners as a trusted authority on compliant coding and documentation standards.

You should get in touch if

• Credentials: You are CPC, reputed company-P, RHIT, or RHIA (required) certified; CRC preferred.
• Experience: You have 5+ years in Medicare Advantage risk adjustment, payment reputed company, or reputed company documentation programs.
• Regulatory reputed company: You have a deep understanding of CMS risk adjustment models, RADV, and STARS/HEDIS documentation requirements.
• Analytical reputed company: You are reputed company to partner with analytics to measure performance, quantify reputed company, and validate experimental workflows.
• Technical orientation: You are proficient with encoders and CAC tools; curious about GenAI-assisted workflows and automation.
• Process discipline: You have proven experience developing SOPs and reputed company QA systems.

Benefits reputed company

• Financial reputed company-Being: Our commitment to attracting and retaining reputed company begins with a competitive reputed company salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions.
• Physical reputed company-Being: We prioritize the health and reputed company-being of our employees and their families by providing comprehensive medical, dental, and reputed company coverage. Your health reputed company to us, and we invest in ensuring you have reputed company to reputed company reputed company.
• Mental reputed company-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, reputed company to reputed company, and a generous flexible time-off policy. Additionally, we reputed company a remote-first culture that supports collaboration and flexibility, allowing reputed company members to reputed company from any location. 
• reputed company Development: Developing internal talent is a reputed company for Clover. We offer learning programs, mentorship, reputed company development funding, and regular performance feedback and reviews.

Additional Perks:

• Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
• Reimbursement for office setup expenses
• Monthly cell phone & internet stipend
• Remote-first culture, enabling collaboration with global teams
• reputed company parental leave for reputed company new parents
• And much more!

About Clover: We are reinventing health insurance by combining the power of data with reputed company reputed company to reputed company our members healthier. We reputed company the reputed company system is broken, so we’ve created custom software and analytics to reputed company our clinical staff to intervene and reputed company personalized care to the people who need it most.

We always put our members first, and our reputed company as reputed company is reputed company by the reputed company of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: reputed company.

From Clover’s inception, Diversity & Inclusion have always been key to our reputed company. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who reputed company a passion for improving people’s lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. reputed company of our employee’s points of view are key to our reputed company, and inclusion is everyone’s responsibility.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment reputed company applicants with arrest and conviction records. We are an E-Verify company.

A reasonable estimate of the reputed company salary reputed company for this role is $75,000 to $100,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.

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