Risk Adjustment Revenue Cycle Analyst

Job not on LinkedIn

🕒 May 1

🏖️ 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 Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

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 • Assess the client's needed action plan based on structured assessments every quarter • 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 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 • Maintains professional license and certifications (where applicable) and attends training conferences/webinars as necessary

🎯 Requirements

• Associate Degree • 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 • Must be detail-oriented, follow instructions, and work independently with minimal supervision

🏖️ Benefits

• Medical, dental and vision coverage effective 1st of the month following date of hire • Flexible spending • Company-paid life insurance and short-term disability • Paid Time Off • Paid holidays