Medicare Risk Adjustment & RCM Specialist

ExactCare Pharmacy; New Jersey; Hybride; USD 65 000 - 100 000; Plein temps

Avantages offerts par ce poste

Comprehensive benefits

Résumé du poste

Capstone is seeking a Client Service Liaison to actively assess and monitor the Medicare revenue cycle for PACE programs. You will interpret payment data, identify variances, and support timely premium payments while partnering with client financial teams.

In this remote role, you will conduct quarterly assessments, visit sites as needed, onboard new clients, train via webinars, and coordinate with internal teams to ensure client satisfaction and opportunities for service expansion.

Qualifications

• Minimum three years of experience in Hierarchical Condition Categories (HCC) or risk adjustment.
• Experience with Risk Adjustment Analytics preferred.
• Knowledge of CMS Medicare revenue cycle in risk adjustment payment model preferred.

Responsabilités

• Assess Medicare revenue cycle for PACE programs using CMS returns files and input from Capstone analytics teams.
• Assess client needs and develop quarterly action plans including on-site visits or virtual meetings.
• Develop and strengthen Capstone client relationships within the assigned panel.
• Onboard new clients and coordinate with internal teams to ensure a smooth transition.
• Monitor client needs and propose additional services or improvements as appropriate.
• Provide training and education via webinars as needed.
• Maintain HIPAA compliance and security requirements.
• Ensure client satisfaction by resolving issues quickly and creatively.

Connaissances

Written communication

Verbal communication

Prioritization

Project coordination

Presentation skills

Detail oriented

Independent work

HIPAA compliance

Adaptability

Formation

Associate Degree

Bachelor’s degree preferred

Outils

MS Word

Excel

PowerPoint

Description du poste

Capstone is seeking a Client Service Liaison to actively assess and monitor the Medicare revenue cycle for PACE programs. You will interpret payment data, identify variances, and support timely premium payments while partnering with client financial teams.

In this remote role, you will conduct quarterly assessments, visit sites as needed, onboard new clients, train via webinars, and coordinate with internal teams to ensure client satisfaction and opportunities for service expansion.