Risk Adjustment Auditor

ChenMed

1d • Onsite

About The Position

We’re unique. You should be, too. We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team. The Risk Adjustment Auditor works in a collaborative effort directly with physicians, their office staff, and other support departments to review medical records and other clinical documentation to identify appropriate medical charts and records for compliance with federal coding regulations and guidelines. A major focus of the position is to ensure that medical documentation and supportive evidence complies with risk adjustment initiatives, improving revenue cycle and denial of payments.

Responsibilities

• Audits medical record documentation to identify under-coded and up-coded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues.
• Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services.
• Interacts with other patient care providers regarding policies, procedures, and regulations; obtains clarification on conflicting, ambiguous, or non-specific documentation.
• Instructs, and/or provides support to medical providers and medical coding analysts as appropriate regarding coding compliance documentation, and regulatory provisions.
• Reviews, develops, modifies, and/or adapts relevant procedures, protocols, and data management to ensure that Medical Risk Adjustment operations meet the requirements.
• Interacts with providers and management to review and/or implement codes and to update documentation.
• Ensures strict confidentiality of all records.
• Attends coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.
• Performs other duties as assigned and modified at manager’s discretion.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees