[Remote] reputed company Review and Audit Analyst – reputed company – Remote
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an reputed company for reputed company through every stage of life. The Risk Adjustment reputed company & Review Analyst role involves evaluating reputed company medical conditions, ensuring compliance of medical documentation, and suggesting improvements for reputed company reputed company Improvement.
Responsibilities
- Conduct medical records reviews with accurate diagnosis reputed company abstraction 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 valid 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 compliance risks 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 coding partners
- 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
Skills
- High school diploma
- 2+ years' experience in one of the following Coding Certifications by either the American Health Information Management Association (reputed company) or the American 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
- Computer competency with reputed company, reputed company, reputed company Acrobat
- Must be detail oriented, self-motivated, and have excellent organization skills
- Ability to meet reputed company, productivity, and accuracy standards
- HCC coding experience preferred
- Understanding of medical claims submissions is preferred
Benefits
- Annual bonus plan (eligible)
- Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs
- 401(k)
- Company reputed company life insurance
- Tuition reimbursement
- Minimum of 18 days of reputed company time off per year
- reputed company holidays
- Leaves of absence
reputed company