Risk Adjustment Quality Lead Analyst

Job Summary

A company is looking for a Quality Review & Audit Lead Analyst.

Key Responsibilities

• Drive performance and provide support, feedback, education, and training on value-based metrics specific to risk adjustment
• Develop, implement, and present risk adjustment training and informative material to various audiences
• Support partnerships to develop programs for accurate and compliant risk capture

Required Qualifications

• Bachelor's degree in health care, nursing, business management, or related field
• Minimum 5 years' experience in coding, risk adjustment revenue/policy adherence, and/or physician practice management
• Coding certification required (e.g., CPC, CCS-P, CPCO, RHIT, RHIA, CRC)
• Experience in claims processing and revenue cycle management preferred
• Experience in a clinical field or practice management background strongly preferred