Risk Adjustment Coordinator

Posted 3 days ago

pacer groupDenver (CO)

Medical Records Specialists Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

SENIORITY

Senior

SALARY

$28.00 - $30.00 per hour

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About the role

Risk Adjustment Coordinator

Location: Remote Schedule: Standard, 40 hours per week Duration: 3 Months Pay Range: $28.00- $30/hourly

Position Summary: Under the general direction of the Manager, Risk Adjustment Coding Quality, the Risk Adjustment Coordinator is responsible for supporting enterprise risk adjustment programs by performing the following duties:

Coordinate chart retrieval projects by:
Ensuring that records are routed to the appropriate resources.
Investigating all non-participating provider chart requests and escalating to the appropriate resource as needed.
Distributing related documents and data files to providers and monitoring them through to resolution.
Escalating issues in a timely manner to ensure deliverables and due dates are maintained.
Organize and coordinate the production, distribution, storage, and archiving of documents and data files while maintaining Protected Health Information (PHI) security protocols.
Coordinate and schedule provider appointments to support risk adjustment education and audit reviews.
Monitor the central risk adjustment mailbox and route correspondence to the appropriate associates within the department.
Run and maintain basic Microsoft Access queries and Microsoft Excel workbooks to monitor risk adjustment-related artifacts that support the program.

Serve as the Subject Matter Expert (SME) for Providers, Provider Network Management, and other customers regarding risk adjustment programs and related applications (e.g., NaviNet, vendor chart retrieval applications) by researching issues with internal processes or vendor applications, interfacing with vendors as needed, and documenting and delivering resolutions. Maintain a thorough knowledge of risk adjustment programs across all supported lines of business. Maintain and explore new provider EMR access for all lines of business. Serve as the point person for ordering, securing, and maintaining departmental supplies. Required Skills & Experience Minimum Qualifications:3 to 5 years of experience in Healthcare, Claims Processing, Administrative Support, Provider Relations, or a combination of related experience.

Additional Qualifications: Minimum of 3 years of experience in a Claims, Managed Care, and/or Healthcare environment with a strong working knowledge of business computer programs, applications, and systems. Highly organized with strong written and verbal communication skills. Proficient in Microsoft Excel, Microsoft Access, and Microsoft Word. Basic understanding of medical coding and health information data.1–2 years of experience retrieving medical records from EMR systems preferred.

Education: High School Diploma or GED required.

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