Risk Adjustment Revenue Cycle Analyst

Job not on LinkedIn

November 5

🏖️ New Jersey – Remote

Although this job is listed in New Jersey, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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ExactCare

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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.

501 - 1000 employees

Founded 2009

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

📋 Description

• Completes quarterly assessment for assigned panel with input from all Capstone departments, including but not limited to coding, auditing, & quality assurance. • Assesses client needs based on structured assessments every quarter. • Coordinates all Capstone services to the clients in the assigned panel via quarterly plans including client visits, conference calls, surveys, etc. • Develops and strengthens risk adjustment client relationships in defined assignment panel. • Works with CVHC Account Management team and Capstone internal team to coordinate new client onboarding. • Monitor client needs and recommend additional services and/or improvements to current services, when appropriate. • 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 additional training and education to the clients (other than quarterly review) via webinar. • Provides support and assistance to other Capstone teams in relationship to assigned client panel. • Develops and maintains master schedules for all clients in assigned client panel. • Participates in internal interdisciplinary calls regarding clients in assigned client panel.

🎯 Requirements

• Associate Degree • Minimum three years of experience providing clinical documentation Improvement training. • Minimum three years of experience in Hierarchical Condition Categories (HCC) or risk adjustment. • Preferred: Knowledge of or experience in Risk Adjusted contracting or provider groups. • Preferred: Experience with Risk Adjustment Analytics strongly preferred. • Proficient with MS Word, Excel, PowerPoint, • Comfortable with learning and becoming an expert on new and proprietary software. • 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