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Alignment Health
Alignment Health
501 – 1,000 कर्मचारी
बीमास्वास्थ्य बीमास्वास्थ्य सेवा
Alignment Health एक स्वास्थ्य बीमा कंपनी है, जिसका उद्देश्य मेडिकेयर सदस्यों—विशेष रूप से वरिष्ठ नागरिकों, दीर्घकालिक स्वास्थ्य समस्याओं के साथ जीवन बिताने वाले लोगों और कमजोर स्वास्थ्य वाले व्यक्तियों—की देखभाल को बेहतर बनाना है। 2013 में स्थापित यह कंपनी व्यक्तिगत देखभाल मॉडल को प्रौद्योगिकी और चौबीसों घंटे उपलब्ध कंसीयर्ज देखभाल टीम के साथ जोड़ती है, ताकि विश्वसनीय स्थानीय प्रदाताओं के साथ सहायता का समन्वय किया जा सके। इसका कार्य स्वास्थ्य सेवा प्रदान करने और बीमा, दोनों क्षेत्रों में फैला है, जिसमें सदस्यों के लिए देखभाल को अधिक सुलभ, तत्पर और लागत-सचेत बनाने पर ध्यान दिया जाता है। Alignment Health एक बढ़ते हुए स्वास्थ्य सेवा संगठन में नियुक्तियां करती है, जो मेडिकेयर समुदायों की आवश्यकताओं को पूरा करता है।
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कंपनी की नौकरियाँ

Medicare Risk Adjustment Coding Auditor (CRC) - United States Remote

Audit Medicare risk-adjustment coding and CMS data quality for Alignment Health while supporting accurate documentation, compliance, and care for seniors and chronically ill patients.

USसंयुक्त राज्य
$64,384 – $96,577 / वर्ष
रिमोटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीलेखा परीक्षक

विवरण

  • Conduct quality assurance audits of the internal Coding Analyst team to validate coding and abstraction accuracy against the 95% HCC standard
  • Track and report the progress of quality audits conducted for coding vendors
  • Validate the accuracy and quality of data submitted to Alignment Health for CMS reporting
  • Partner with Risk Adjustment Management on MRA data validation and coding audits
  • Review reconciliation data, data-flow integrity, UAT results, high-cost or low-risk-score members, retrospective charts, and other risk-adjustment activities
  • Analyze audit findings and communicate results to the Manager
  • Use audit findings to support physician and clinical staff training, documentation improvements, and system or process enhancements
  • Handle patient PHI in accordance with HIPAA requirements for use, protection, and disclosure
  • Follow applicable regulations and organizational policies and procedures
  • Keep coding, compliance, and HCC knowledge current through ongoing professional and technical development
  • Complete other assigned responsibilities

आवश्यकताएँ

  • At least three years of Medicare risk-adjustment coding experience in a medical group or health plan
  • High school diploma or GED
  • Completion of a medical coding training program
  • Technical school training or coursework leading to coder certification
  • Required certification as a CCS, CCS-P, CPC, or CRC
  • Proficiency with Microsoft Office, including Excel, Word, and Outlook
  • Prior experience using Epic, Allscripts, and EZCap
  • Strong written and verbal communication skills
  • Capacity to lead, teach, and collaborate with colleagues
  • Ability to build and maintain productive relationships with diverse members, managers, employees, and vendors
  • Ability to perform mathematical calculations and accurately calculate basic statistics
  • Advanced problem-solving and reasoning ability
  • Ability to manage competing priorities in a fast-paced environment
  • Ability to interpret and analyze statistical reports
  • Ability to follow HIPAA requirements and applicable federal, state, and local regulations
  • Ability to maintain the continuing education units required for coding certifications

लाभ

  • Opportunities for professional growth and innovation
  • Continuing education and professional development through workshops, industry publications, professional networks, and professional societies
  • Coding-certification continuing education units
  • Reasonable accommodations for employees with disabilities
  • Equal employment opportunity

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