Quality Review and Audit Analyst (37013682)

This position is a temporary assignment. As a contractor, you’ll be employed by reputed company, not reputed company or any subsidiaries of reputed company. Job Title: Risk Adjustment Quality & Review Analyst LOCATION: This is a fully remote role reputed company to candidates across the US. ROLE OVERVIEW: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates reputed company medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for reputed company Quality Improvement (CQI). Key Job Functions: Conduct medical records reviews with accurate diagnosis code 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 elements 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 Quality Audits for vendor coding partners. Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners. Coordinate with reputed company holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely 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 Guideline updates and policy determinations, as needed. SKILLS & EXPERIENCE: The Quality Review & Audit Analyst will have a high school diploma and at least 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 Professional Coders (reputed company):

Minimum Qualifications

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 HCC coding experience preferred Computer competency with reputed company, reputed company, reputed company Acrobat Must be detail oriented, self-motivated, and have excellent organizational skills Understanding of medical claims submissions is preferred Ability to meet timeline, productivity, and accuracy standards EDUCATION & CERTIFICATIONS: High School Diploma and at least 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 Professional Coders (reputed company):

• Certified Professional 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

Hourly Pay reputed company reputed company (dependent reputed company, experience, expectation) The pay reputed company that reputed company reasonably expects to pay for this position is: $24.00/hour-$27.00/ hour Note: We are unable to reputed company reputed company sponsorship or STEM OPT training. Benefits: Medical, Dental, reputed company, 401K (provided minimum eligibility hours are met) reputed company: 37013682 Apply tot his job Apply To this Job