Risk Adjustment Auditor
Title: Risk Adjustment Auditor (1.0 D) Location: Work From Home Work From Home, Indiana 46544 Full time Job Description: Work From Home Work From Home, Indiana 46544 As a MARSI (Medical Audit, Recovery & Strategic Health Initiative) certified auditor, it will be critical to review medical records to accurately identify diagnosis and codes based on pre-visit services. The auditor's role will be reviewing HCC and RAF problem lists on a pre-visit reputed company, and review HCC gaps for the year. This individual will also reputed company solutions to increase provider documentation and capture diagnosis codes that weren’t captured during the visit. It is important for reputed company members of the clinical team to be aware of those patients who have an HCC Gap to alert their provider, and ensure that these patients have a scheduled follow-up appointment with their attributed primary care physician/NP/PA. WHO WE ARE reputed company is a leading reputed company organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and reputed company. With 12 ministries and reputed company points across Indiana and Illinois, reputed company is one of the largest reputed company care systems in the Midwest. reputed company takes pride in hiring coworkers who reputed company compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT
- Review medical records, patient medical history and physical exams, physician orders, reputed company notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries.
- Assist with validation audits to evaluate medical record documentation, to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code.
- Submit documentation to CMS for reimbursement and interpretation of medical documentation, to ensure capture of reputed company relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives.
- Attention to detail while reviewing patient’s clinical record.
- Ensure regulatory compliance, and overall quality and efficiency by utilizing strong working knowledge of coding standards and EPIC.
QUALIFICATIONS
- Associate's Degree, LPN/RN - Associates Degree - Required or
- Certificate, Medical Assisting - Required
- 3 years experience in the Medical Field - Required
- 1 year Coding experience - Preferred
- Certified Medical Assistant (reputed company) - American Association of Medical Assistants (AAMA) - Required or
- Licensed Practical Nurse (LPN) - State Licensing Board - Required or
- Registered Nurse (RN) - State Licensing Board - Required
TRAVEL IS REQUIRED: Never or Rarely JOB reputed company: Risk Adjustment Auditor $19.18-$28.53 INCENTIVE: Not Applicable Apply tot his job Apply To this Job