Your
Talent. Our Vision. At CareMore, a proud member of the
Anthem, Inc. family of companies specializing in providing patients a complete
and pro-active health care experience, it’s a powerful combination. It’s
the foundation upon which we’re creating greater access to care for our members,
greater value for our customers and greater health for our communities. Join us
and together we will drive the future of health care.
Responsible
for ensuring complete risk scores and accurate revenue and mitigating payment
error risk via auditing, education, and training for proper diagnosis coding
and documentation practices.
Primary
duties may include, but are not limited to:
·
Identifies opportunities to improve accuracy and completeness
for revenue impact.
·
Translates data to provide answers for provider consultations in
order to improve medical record documentation and risk scores.
·
Provides feedback to providers on performance improvement
opportunities; tracks and prioritizes projects to improve coding and
documentation outcomes.
·
Develops and implements action plans to address issues
identified through data analysis.
·
Provides oversight, guidance, and training to partner providers
and clinicians related to CMS guidelines and HCC best practices.
·
Develops training programs and tools; performs internal process
and policy audits.
Requires
BA/BS in health sciences, health management, or nursing;
6 years
of experience in healthcare including provider relationship management, ICD-9
coding, and experience in a consultative role, including 3 years of CMS Risk Adjustment
experience; or any combination of education and experience, which would provide
an equivalent background.
CPC or
CCS from accredited source (e.g. American Health Information Management
Association, American Academy of Professional Coders or Practice Management
Institute) or equivalent certification required.
Experience
developing training programs and provider tools required.
Proficiency
in programming, query and/or data analysis tools/software required.
Anthem,
Inc. is ranked as one of America’s Most Admired Companies among health insurers
by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for
Diversity. To learn more about our company and apply, please visit us at
careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.