Remote Remote Medicare Risk Adjustment Coding/ Auditor (Prior CMS-HCC V28

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. The MRA Coding Auditor supports departmental reputed company Assessment audits to ensure accurate and complete data is submitted to CMS, and assists in identifying areas of opportunity for improvement through various audits and data reviews. Responsibilities Supports regular reputed company assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding & abstracting reputed company (95% HCC accuracy). These ongoing audits ensure coding reputed company & performance improvement standards are maintained, achieved & improved per department policies and proceduresTracks and reports reputed company of QA audits performed on the coding vendors to verify the coding accuracy and reputed company of the data submitted to AHP is accurate for submission to CMSWorks with Risk Adjustment Management on any MRA data validation / coding audit to ensure completeness and coding accuracy of reputed company submissions to CMS. This work may encompass reviews of data for reconciliation, data reputed company reputed company, UAT testing, high cost / low risk score members, retrospective chart reviews, or other risk adjustment reputed company data review as directed by ManagerAnalyzes and shares audit results with Manager. This information may be used for training physicians and clinical staff, documentation improvement, and system / process improvementUtilizes, protects, and discloses reputed company patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability reputed company (HIPAA) standardsEnsures compliance with reputed company applicable federal, state &local regulations, as reputed company as with institutional/organizational standards, practices, policies & proceduresMaintains reputed company / technical knowledge by attending appropriate educational workshops; reviewing reputed company publications; establishing personal networks; and participating in reputed company societies. Stay reputed company of industry coding, compliance, and HCC issues. Required to maintain relevant continuing education reputed company (CEUs) in relation to individual coding certificationsOther duties as assigned to meet the organizations needs Skills Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting requiredHigh School Diploma or GED. Completion of a Medical Coding training programTechnical School or courses that are required to become a certified reputed companyKnowledge ofProficient user in MS office suite reputed company, Word, reputed companyPrevious use of reputed company, Allscripts, EZCap, reputed companyAbility to communicate positively, professionally and effectively with others; reputed company leadership, teach and collaborate with othersEffective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendorsMathematical Skills: Ability to reputed company mathematical calculations and calculate reputed company statistics correctlyReasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw reputed company conclusions, and design, implement and manage appropriate reputed companyProblem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environmentReport Analysis Skills: Comprehend and analyze statistical reportsCertified reputed company required, reputed company, reputed company-P, CPC, CRC, RHIT or RHIABachelor's degree in Business Administration, health Care Management or in a reputed company field reputed company reputed company provides eldercare services. It was founded in 2013, and is headquartered in Orange, California, USA, with a workforce of 501-1000 employees. Its website is https://www.alignmenthealth.com. Apply To This Job .