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Coordinator Risk Adjustment

22nd Century Technologies, Inc.

  • Philadelphia, PA
  • Today
  • Remote

    Highlights

    Serve as Subject Matter Expert for Providers, Provider Network Management and other customers regarding risk adjustment programs and related applications (e.g., NaviNet, vendor chart retrieval application, etc.) by researching issues with internal process or vendor applications, interfacing with vendors as needed, and documenting/ delivering resolution. Duties: Under the general direction of the Manager, Risk Adjustment Coding Quality, the Coordinator Risk Adjustment is responsible for supporting enterprise risk adjustment programs by completing the following duties: " Coordinate chart retrieval projects by: o ensuring that records are routed to appropriate resources.

    Numbers & Facts

    LocationPhiladelphia, PA (
    Remote    )
    IndustryComputer/IT Services
    Company Size100 to 499 employees
    Year Founded1997
    Websitehttps://www.tscti.com/careers-0

    Description

     
Preferably EST, but open to other time zones besides PST.
    Duties:

    Under the general direction of the Manager, Risk Adjustment Coding Quality, the Coordinator Risk Adjustment is responsible for supporting enterprise risk adjustment programs by completing the following duties:

    " Coordinate chart retrieval projects by:
    o ensuring that records are routed to appropriate resources
    o investigating all non-participating provider chart requests and escalating to appropriate resource as needed
    o distributing related documents and data files to providers and monitoring through to resolution
    o escalating issues in a timely manner to ensure deliverables and due dates are maintained
    " Organize and coordinate the production, distribution, storage and archiving of documents and data files while maintaining Protected Health Information security protocols.
    " Coordinate and schedule provider appointments to support risk adjustment education and audit reviews.
    " Monitor central risk adjustment mailbox and route correspondence to appropriate associates within the department.
    " Run and maintain basic MS Access queries and MS Excel workbooks to monitor risk adjustment related artifacts that support the program.
    " Serve as Subject Matter Expert for Providers, Provider Network Management and other customers regarding risk adjustment programs and related applications (e.g., NaviNet, vendor chart retrieval application, etc.) by researching issues with internal process or vendor applications, interfacing with vendors as needed, and documenting/ delivering resolution
    " Maintains a thorough knowledge of risk adjustment programs across all supported lines of business. Maintains and explores new provider EMR access for all LOBs
    " Serves as point person for ordering, securing and maintaining departmental supplies.

    Skills:

    Minimum 3 to 5 years experience in Healthcare, Claims Processing, Administrative, Provider Relations and/or combination of experience

    Other Skills:
    " Minimum of 3 years' experience in Claims, Managed Care and/or Healthcare environment with strong working knowledge of business computer programs, applications and systems required.
    " Highly organized with strong written and verbal communication skills.
    " Proficient with MS Excel, MS Access and MS Word.
    " Basic understanding of medical coding and health information data required.
    " 1-2 year experience retrieving Medical Record from EMR preferred

    Education:

    High School/GED Required.

    Skills:

    Required

    • HEALTHCARE EXPERIENCE
    • CLAIMS PROCESSING
    • ADMINISTRATIVE EXPERIENCE
    • PROVIDER RELATIONS
    • MANAGED CARE

    Additional

    • MEDICAL CODING
    • HEALTH INFORMATION DATA
    • RETRIEVING MEDICAL RECORDS FROM EMR
    • ORGANIZATIONAL SKILLS
    • WRITTEN COMMUNICATION
    • VERBAL COMMUNICATION
    • BUSINESS COMPUTER PROGRAMS
    • MS EXCEL
    • MS ACCESS
    • MS WORD
    Languages: English( Speak, Read, Write )


    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

    About Company

    22nd Century Technologies, Inc., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the United States. Founded in 1997, 22nd Century Technologies is a Certified National Minority Business Enterprise with 6,000+ people including 600+ Cyber SMEs nationwide supporting our customers in all 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd Century has 14 offices throughout the United States. As part of our unrelenting focus on quality and compliance, 22nd Century Technologies’ delivery is based on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 quality processes. With a strong focus on the public sector, 22nd Century currently holds government contracts with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115+ Local agencies, and 37 School Districts. In the last three years, we have expanded our services to Fortune 500 and other commercial clients and currently support 80+ commercial clients.

    Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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