ChenMed
Risk Adjustment Auditor
Job Description
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.ESSENTIAL JOB DUTIES/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.
PAY RANGE:
$54,358 - $77,655 SalaryThe posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
https://chenmed.makeityoursource.com/helpful-documents
We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.
Current employees, if you want to apply to our internal career site, please click HERE
Current Contingent Worker please see job aid HERE to apply
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