Job Description

We are currently seeking a highly motivated Risk Adjustment Coordinator to support our team in retrieving medical records from providers in the Inland Empire region! The Risk Adjustment Coordinator is responsible for retrieving records from EMR systems as well as in-office from physician offices.

We are seeking candidates who are comfortable working hybrid both from home and traveling into provider offices throughout Inland Empire.

Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What Youll Do

• Contact and collect medical records onsite from Providers offices or via EMR access documentation for coders/audits/sweeps retrieval
• Collect and summarize meeting minutes from the meeting.
• Coordinate office activities (such as scheduling meeting for internal/external and provider visit)
• Prepare reports for the meeting (weekly/monthly or quarterly if needed)
• Distribute E-Fax
• Responding to emails and faxes specifically to the team
• Create/update monthly list for Active Members/Member Without Office Visit in IPA folder.
• Receive and organize data from external sources.
• Understand the principles of HIPAA and maintain confidentiality of patient health information.
• Understand the principles of Risk Adjustment based CMS standards.
• Communicate internally and externally as needed to gather necessary data.
• Attend provider and interdepartmental calls in accordance with exceptional customer service.
• Promotes a positive working relationship between NMM IPAs and health plan.
• Attend IPA and health plan meetings as required and respond to questions/inquiries in a timely manner.
• Performs duties in a professional manner utilizing time and resources efficiently.
• Other duties as assigned

Qualifications

• Must be able to travel up to 50% of work time.
• High School diploma or GED required.
• Must value operating in a collaborative and cooperative environment.
• Ability to show initiative good judgement and resourcefulness.
• Excellent written and oral communication skills as well as strong interpersonal.
• Excellent organizational decision-making and multi-tasking skills.
• Excellent presentation verbal and written communication skills and ability to collaborate with co-workers senior leadership and other management.
• Proven ability to prioritize and organize multi-faceted/multiple responsibilities simultaneously in a fast paced changing environment while meeting deadlines and turnaround time requirements.
• Must be able to work independently utilizing all resources available while staying within the boundaries of duties.
• Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers members business plans strategies and other sensitive information is required.
• Proficient with Microsoft Office (Word Excel Power Point) and EZCAP.

Environmental Job Requirements and Working Conditions

• The national target pay range for this role is $20 - $26 per hour. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.
• This role follows a hybrid work structure where the expectation is to work at home on a daily basis with travel up to 50% of the time as needed in the surrounding areas within Inland Empire.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.

Required Experience:

IC

Job Tags

Hourly pay, Full time, Work at office

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