Risk Adjustment Data Entry (On-Site)
About The Position
General Summary: This role focuses on the improved documentation of acuity for the capitated GMG patient population through the Review Medical History process, Intake visits and other outreach efforts. Also helps with other Managed Care projects. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. 1. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3. Must always adhere to customer service expectations including in-person and virtual (via telephone, or telehealth applications) communication. 4. Participates in other Managed care projects to include but not limited to marketing events, and Medicare Open enrollment period. 5. Reviews reports to identify areas for improvement or needed action to meet departmental goals. 6. Supports team members in all aspects of the Risk Adjustment process to ensure that defined timelines and departmental goals are met. 7. Adhere to all confidentiality and HIPAA requirements as always outlined within Gonzaba Medical Group Operating Policies and Procedures in all ways and with respect to any aspect of the data handled or services rendered. 8. Other duties as assigned.
Requirements
- Minimum high school education or equivalent.
- Experience in a clinic, doctor’s office or hospital with a minimum of one-year experience preferred.
- Computer Skills: Skilled in use of computer/EMR systems. Knowledge of Word processing software, spreadsheet software, Internet, and database software.
Nice To Haves
- Medical Assistant Certificate or Current TX LVN license preferred.
- CPR with AED certification preferred.
Responsibilities
- Maintain accurate database of GMG capitated patients, update database monthly from enrollment and disenrollment reports.
- Accurately update the database to track each stage of the RMH process. This is vital to an effective process and accurate reports.
- Prepare audit documents as defined; create logical batches for reviewers.
- Process completed audits for timely data entry into EMR.
- Assist with teaching clinical staff how to identify patients needing RMH review, preparing RMH notes for the provider, and processing RMH encounter notes; also teach how and when to schedule future RMH appointments.
- Keep PCP, clinical staff and Managed Care team members informed of pertinent findings/issues uncovered.
- Track & report completed RMH DOS for CMS submission.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
