Risk Adjustment Administrative Representative
Core
Obtaining accurate healthcare information from providers to ensure appropriate clinical care and maintain accurate payment levels.
Role type
Administrative representative for risk adjustment programs
Builds
Risk adjustment programs and data transfer between providers and the company
Domain
Healthcare administration and insurance
Deliverable
dashboards & analysis
Required skills
Medical records retrieval, Data analysis, Record retrieval, ICD-9/10 codes knowledge, Microsoft Office proficiency
Responsibilities
Conducts analysis of data, provider or member outreach, and/or record retrieval; Assists in the acquisition of medical records; Loads medical records into coding system and links records to appropriate chart IDs; Facilitates transfer of data and information in support of risk adjustment programs; Downloads medical records from Electronic Medical Record (EMR) systems; Assists with the medical record quality assurance process; Manages, maintains, and tracks ad hoc retrospective projects; Prioritizes work across providers and/or external vendors; Travels to worksite and other locations as necessary.