Risk Adjustment Coordinator

» Risk Adjustment Coordinator
Finance & Accounting
in Atlanta
, GA
Reference: 19-02598

Description:

Supports quality improvement interventions by collecting medical records data. Interface via phone, fax and mail with providers and contracted vendors. Maintain confidentiality of protected health information.

Key Duties and Responsibilities:

  • Responsible for all phases of the medical record request process for sensitive providers from identification, outreach, follow up to ultimate disposition
  • Review medical records for completeness and compliance with CMS guidelines
  • Follow up with providers as necessary
  • Coordinate with internal departments (such as Network Management, Provider Relations, Retrospective Review, Claims Recovery) and vendors to ensure timely completion of medical record request to meet departmental goals and CMS deadlines
  • Participate in process development and testing of new process implementation
  • Perform all other duties as assigned

Education:

  • A High School GED Required

Work Experience:

  • 1+ year of experience in relevant work experience

Skills:

  • Demonstrated problem solving skills
  • Demonstrated interpersonal/verbal communication skills
  • Demonstrated written communication skills
  • Demonstrated organizational skills
  • Demonstrated time management and priority setting skills

Technology:

  • Microsoft Outlook
  • Microsoft Word
  • Microsoft Excel
  • Adobe Acrobate

Level of Supervision Received:

  • Under general supervision, proceeds alone on regular duties, referring questionable cases to supervisor