University of California
Medicare Advantage Risk Adjustment Provider Documentation Trainer and Auditor
University of California, Los Angeles, California, United States, 90079
Description
As the Medicare Advantage Risk Adjustment ProviderDocumentation Trainer and Auditor, you will be an expert in risk adjustment coding and documentation,working closely with physicians, IPA coders, and risk adjustment teams associatedwith the health plan. You will:Conduct medical record audits for physicians(MD, DO, or NP) to ensure documentation and coding accuracy of ICD-10 CM codesrelated to chronic conditionsAnalyze coding patterns within medical groups.Provide customized education and updatingeducational materials for providers and medical groups.Participate in additional audit activities forCMS RADV as needed, including retrospective chart reviews.Travel to provider offices within Los Angelesarea at least three days a week.UCLA Health salary range for this title code is $92,600-202,200/annually. Please note that the department's target pay range is $95,000 - $120,000/annually.
Note: This posted position is 1 of 4 positionsavailable for hire. All applicants will apply through this requisition and ifselected will be hired into one of the available positions.Qualifications
We are seeking a proactive, highly organized,detail-oriented individual with:A Certified Professional Coder (CPC) certificationand a Certified Risk Adjustment Coder (CRC), requiredBachelor's degree (healthcare or relevant field)or equivalent experience/trainingFive or more years of experience with physicianbilling and/or coding, requiredThree or more years of recent experience inCMS-HCC Risk Adjustment models V24 and V28, requiredThree or more years of experience in providingeducation to clinical and non-clinical staff, requiredSix or more years of clinic or IPA and/ormanaged care experience, preferredUnderstanding of RADV and audit processes,requiredDetailed knowledge and understanding of ICD-10,CPT and CPT (II), and HCPCS coding systems requiredKnowledge of Medicare Advantage STARS/HEDISprogram and NCQA technical specifications, requiredKnowledge of Medicare Advantage billing/claims submissionand other related actions, preferredKnowledge of HIPAA requirements, anatomy andphysiology, requiredProficient in MS Word, Excel, PowerPoint andOutlook, requiredAbility to work effectively with common officesoftware, coding software, and EMR systems, requiredReliable transportation to conduct ongoingface-to-face interactions with providers in the Los Angeles area, requiredNote: Skills may be subject to test.
As the Medicare Advantage Risk Adjustment ProviderDocumentation Trainer and Auditor, you will be an expert in risk adjustment coding and documentation,working closely with physicians, IPA coders, and risk adjustment teams associatedwith the health plan. You will:Conduct medical record audits for physicians(MD, DO, or NP) to ensure documentation and coding accuracy of ICD-10 CM codesrelated to chronic conditionsAnalyze coding patterns within medical groups.Provide customized education and updatingeducational materials for providers and medical groups.Participate in additional audit activities forCMS RADV as needed, including retrospective chart reviews.Travel to provider offices within Los Angelesarea at least three days a week.UCLA Health salary range for this title code is $92,600-202,200/annually. Please note that the department's target pay range is $95,000 - $120,000/annually.
Note: This posted position is 1 of 4 positionsavailable for hire. All applicants will apply through this requisition and ifselected will be hired into one of the available positions.Qualifications
We are seeking a proactive, highly organized,detail-oriented individual with:A Certified Professional Coder (CPC) certificationand a Certified Risk Adjustment Coder (CRC), requiredBachelor's degree (healthcare or relevant field)or equivalent experience/trainingFive or more years of experience with physicianbilling and/or coding, requiredThree or more years of recent experience inCMS-HCC Risk Adjustment models V24 and V28, requiredThree or more years of experience in providingeducation to clinical and non-clinical staff, requiredSix or more years of clinic or IPA and/ormanaged care experience, preferredUnderstanding of RADV and audit processes,requiredDetailed knowledge and understanding of ICD-10,CPT and CPT (II), and HCPCS coding systems requiredKnowledge of Medicare Advantage STARS/HEDISprogram and NCQA technical specifications, requiredKnowledge of Medicare Advantage billing/claims submissionand other related actions, preferredKnowledge of HIPAA requirements, anatomy andphysiology, requiredProficient in MS Word, Excel, PowerPoint andOutlook, requiredAbility to work effectively with common officesoftware, coding software, and EMR systems, requiredReliable transportation to conduct ongoingface-to-face interactions with providers in the Los Angeles area, requiredNote: Skills may be subject to test.