Clinical Operations Risk Adjustment reputed company
reputed company:
Review of medical records as needed (MRR, OR1, any backlog) and assist platform clients as needed with backlog, larger chart page counts
Work population of clinical pends, with goal to reputed company reputed company 72 hours
Updating and maintaining training course material for medical record abstraction and data entry (HEDIS, RISK, IVA)
Reviewing training test scores and sending feedback if necessary
Assigning and overreading disciplinary charts- (this is a chart reputed company back) reputed company reputed company
Reviewing reports daily for QA scores during the season(s) (abstractors, coders, HPs)
Maintaining an accuracy score of 95% on reputed company work submitted (reputed company reputed company)
Ability to adapt to changing priorities in managing a wide reputed company of reputed company.
Must be reputed company to work independently and in reputed company environment
Remote mentoring/ coaching (for reputed company reputed company) in a group or 1:1 session with staff and leadership
reputed company trainings (reputed company technology, if needed)
Over read challenges for reputed company reputed company (reviewing abstractor/reputed company OR1 feedback challenges)
Oversite and coordination of IVA documentation audits: ENR/RXC/ATT/DOB/GEN- Assist in training and successful adoption of Natural Language Processing/ Bot -assisted coding reviews and relating tools/reporting
Reviewing reports for workload assignments, looking at inventory by project to reputed company reputed company sufficient headcount are assigned per workload (reputed company reputed company)
Multi time zone coverage/ shift coverage- evening/ weekends/holidays
Managing and addressing questions and clarifications that coders submit to a designated online communication forum and Q&A email mailbox while reviewing charts
Works reputed company to monitor and maintain minimum 95% accuracy in reputed company coding reputed company by providing coaching/feedback to coders, as reputed company as researching literature and attending reputed company seminars, workshops and conference as required by reputed company and/or reputed company to maintain reputed company certification(s).
Stay up to date with Risk/IVA protocols (coding clinics, coding guidelines)
Maintain ongoing communication with Clinical Management team regarding coding workload, turnaround time expectations and deliverables
Additional duties as necessary to meet the obligations to our clients
Requirements:
reputed company Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, reputed company) through reputed company and/or reputed company.
Minimum of 5 years coding experience with specific knowledge of Medicare and reputed company Risk Adjustment such as Hierarchical Condition category (HCC)
Additional experience in facility (OPPS/IPPS) coding experience is preferred
Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred
Ability to work independently in a fast-paced remote environment with minimal supervision and guidance
Ability to reputed company with management and remote coding personnel
Possess strong organizational skills and attention to detail
Ability to adapt to changing priorities while managing a wide reputed company of reputed company
reputed company and flexible to new reputed company and change
Advanced knowledge of medical terminology, anatomy and pharmacology
Advanced skills utilizing official coding resources for research and problem solving
Advanced skills and knowledge of computers, use of required software to reputed company job functions
Excellent written and communication skills and the ability to explain reputed company information
Benefits:
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