Risk Adjustment Revenue Cycle Analyst

Job not on LinkedIn

🕒 June 29

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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ExactCare

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2009

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

Healthcare • Healthcare Insurance • Pharmaceuticals

ExactCare is a leading pharmacy care management provider that specializes in medication management for individuals with complex, chronic medical needs. With operations in all 50 states and Washington, D. C. , ExactCare supports more than 100,000 people nationwide, helping them manage their medications in assisted living, long-term care facilities, and at home. Partnering with healthcare organizations, ExactCare aims to improve clinical outcomes by ensuring better medication adherence, reducing readmissions, and lowering overall healthcare costs.

📋 Description

• Completes assessment for assigned panel of PACE programs using CMS returns files and input from all Capstone departments' analytics • Develops and strengthens Capstone client relationships in the defined assignment panel • Works with the Capstone project coordinator to ensure successful new client onboarding • Monitor client needs and recommend additional services and/or improvements to current services • Responsible for ensuring customer satisfaction by resolving issues quickly and creatively • Assist the client with navigating and optimizing the use of service offerings and reports • Provide and/or coordinate additional training and education to the clients (other than quarterly review) via webinar as needed • Provides support and collaborates with other Capstone teams in relation to the assigned client panel • Develops and maintains master schedules for all clients in the assigned client panel • Participates in internal collaboration calls regarding clients in the assigned client panel

🎯 Requirements

• Minimum three years of experience in Hierarchical Condition Categories (HCC) or risk adjustment • Experience with Risk Adjustment Analytics strongly preferred • Knowledge of or experience in Risk-Adjusted contracting or provider groups • Knowledge of CMS Medicare revenue cycle in the risk adjustment payment model • Proficient with MS Word, Excel, and PowerPoint • Comfortable with learning and becoming an expert on new and proprietary software • Highly skilled in written and verbal communication • Highly skilled at establishing priorities and coordinating work activities • Excellent presentation skills • Skilled at performing multiple and complex tasks • Have exceptional initiative and follow-through on projects with minimal supervision or guidance • Must be detail-oriented, follow instructions, and work independently with minimal supervision with highly confidential information per HIPAA regulations

🏖️ Benefits

• medical/dental/vision • flexible spending • company-paid life insurance • short-term disability • voluntary benefits • 401(k) • Paid Time Off • paid holidays