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Alignment Health
Alignment Health
501 – 1 000 Xodimlar
Sog‘liqni saqlashSug‘urtaTibbiy sug‘urta
Alignment Health Medicare a’zolariga, ayniqsa keksalar, surunkali kasalliklar bilan yashayotganlar va nimjon insonlarga tibbiy yordamni yaxshilashga e’tibor qaratadigan tibbiy sug‘urta kompaniyasidir. 2013-yilda tashkil etilgan kompaniya shaxsiylashtirilgan parvarish modelini texnologiya va ishonchli mahalliy xizmat ko‘rsatuvchilar bilan yordamni muvofiqlashtiradigan 24/7 maslahat jamoasi bilan birlashtiradi. Uning faoliyati tibbiy xizmat ko‘rsatish va sug‘urta sohalarini qamrab oladi hamda a’zolari uchun yordamni yanada qulay, tezkor va xarajatlarni hisobga oladigan qilishga qaratilgan. Alignment Health Medicare hamjamiyatlari ehtiyojlariga xizmat ko‘rsatuvchi, rivojlanib borayotgan sog‘liqni saqlash tashkilotining turli yo‘nalishlariga xodimlar yollaydi.
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Kompaniyadagi ish o‘rinlari

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.

USAmerika Qo‘shma Shtatlari
64 384 $ – 96 577 $ / yil
MasofaviyTo‘liq stavkaO‘rta darajaSeniorTalab Qilinadigan Til: inglizchaAuditor

Tavsif

  • 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

Talablar

  • 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

Imtiyozlar

  • 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

O‘xshash ish o‘rinlari

Kreato Global | BPO and Language Solutions

Remote English-Spanish OPI/VRI Interpreter

Kreato Global | BPO and Language Solutions
201 – 500 Xodimlar
LogistikaMehmondo‘stlikSog‘liqni saqlash
ARArgentinaBOBoliviyaBRBraziliyaCLChiliCOKolumbiyaCRKosta-RikaCUKubaDODominikan RespublikasiECEkvadorGTGvatemalaHNGondurasHTGaitiMXMeksikaNINikaraguaPAPanamaPEPeruPRPuerto-RikoPYParagvaySVSalvadorUYUrugvayVEVenesuelaMasofaviyTo‘liq stavkaJuniorDiplom talab qilinmaydiTalab Qilinadigan Til: inglizchaTalab Qilinadigan Til: ispanchaTarjimon

Interpret remotely between English- and Spanish-speaking people in medical, financial, social service, and customer care settings. Provide language support for Kreato Global across Latin America.

Ochish