Risk Adjustment Coordinator

Role Overview

• Contact and collect medical records onsite from Provider’s offices or via EMR access documentation for coders/audits/sweeps retrieval.
• Collect and summarize meeting minutes from the meeting.
• Coordinate office activities (such as scheduling meeting for internal/external and provider visit).
• Prepare reports for the meeting (weekly/monthly or quarterly, if needed).
• Distribute E-Fax.
• Responding to emails and faxes specifically to the team.
• Create/update monthly list for Active Members/Member Without Office Visit in IPA folder.
• Receive and organize data from external sources.
• Understand the principles of HIPAA and maintain confidentiality of patient health information.
• Understand the principles of Risk Adjustment based CMS standards.
• Communicate internally and externally as needed to gather necessary data.
• Attend provider and interdepartmental calls in accordance with exceptional customer service.
• Promotes a positive working relationship between NMM, IPAs, and health plan.
• Attend IPA and health plan meetings as required and respond to questions/inquiries in a timely manner.
• Performs duties in a professional manner, utilizing time and resources efficiently.
• Other duties as assigned.

Requirements

• High School diploma or GED required.
• Must be able to travel up to 50% of work time.
• Must value operating in a collaborative and cooperative environment.
• Ability to show initiative, good judgement, and resourcefulness.
• Excellent written and oral communication skills, as well as strong interpersonal skills.
• Excellent organizational, decision-making, and multi-tasking skills.
• Proven ability to prioritize and organize multi-faceted/multiple responsibilities simultaneously in a fast paced, changing environment while meeting deadlines and turnaround time requirements.
• Must be able to work independently utilizing all resources available while staying within the boundaries of duties.
• Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.
• Proficient with Microsoft Office (Word, Excel, Power Point) and EZCAP.

Benefits

• The national target pay range for this role is $21
• $26 per hour.
• Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
• Health insurance.
• Flexible work arrangements.
• Equal Employment Opportunity employer.
• Affirmative Action employer.