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Risk Adjustment Specialist - Watertown, United States - Atrius Health
Description
SUMMARY
Under general direction, conducts medical record reviews to ensure that all documented chronic disease (HCC) diagnoses are captured allowing the opportunity for optimal health risk scores. Reviews clinical data from EpicCare and outside claims to ensure that all chronic disease (HCC) diagnoses have been identified and appropriately captured on the patient's medical record problem list. Reviews medical record documentation to be sure all chronic conditions on the problem list are substantiated before missing diagnoses are added. Works closely with regional and site clinicians to ensure that all relevant clinical diagnoses are captured in electronic medical record. Is an active member of the Risk Adjustment Team, participating in creating and implementing new initiatives for Atrius Health risk adjustment programs.
EDUCATION/LICENSES/CERTIFICATIONS
Graduate of a state-approved school of nursing as an R.N or , or Graduate of a State-approved program/school for Physician Assistants (P.A). Certification as professional coder (CPC, CCS-P, CCS, CPC-H, CRC-risk, AAPC) preferred with the requirement to obtain certification while working in the position.
EXPERIENCE
At least 3 to 5 years nursing experience with at least three years of clinical experience with chronic disease patient population in an ambulatory or inpatient setting required. Experience in a variety of specialties and multiple diseases within each specialty preferred.
SKILLS
Understanding of medical and business side of healthcare operations required. Strong analytic skills. Strong computer skills and ability to navigate using an electronic health record. Strong oral and written communication skills
Atrius Health is committed to a policy of non-discrimination and equal employment opportunity. All patients, employees, applicants, and other constituents of Atrius Health will be treated with respect and dignity regardless of race, national origin, gender, age, religion, disability, veteran status, marital/domestic partner status, parental status, sexual orientation and gender identity and/or expression, or other dimensions of diversity.
Benefits Include:
· Up to 8% company retirement contribution,
· Generous Paid Time Off
· 10 paid holidays,
· Paid professional development,
· Generous health and welfare benefit package.
Organization
:AdministrationPrimary Location
:Newton MA - RiversideSchedule:flexibleJob
:Professional Non-ClinicalJob Level
:Entry LevelJob Type:Part Time
