Description
The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Responsibilities
The Risk Adjustment Representative 2 follows state and federal regulations as well as internal policies and guidelines while analyzing medical records. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Required Qualifications
• Less than 3 years of technical experience with medical records
• Proficiency in all Microsoft Office applications, including Word and Excel
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Travel is required typically at 50%
• Valid drivers license and vehicle insurance
• We will requirefull COVIDvaccinationfor this jobas weare ahealthcarecompany committed to putting health and safety first for our members, patients, associates and the communities we serve.
• If progressed to offer, you will be required to provide proof offullvaccination or documentation for amedical or religious exemptionconsiderationwhereallowed by law.
Preferred Qualifications
• Bachelor's Degree
• Strong written and verbal communication skills; strong analytical, organizational and time management skills
• Knowledge and experience in health care environment/managed care
• Strong knowledge of ICD-9/10 codes
• Ehub knowledge
Additional Information
• The territory for this position is in Western KY (Bowling Green/Owensboro)
Scheduled Weekly Hours
40 Mid Level Employment Type: OTHER