Risk Adjustment Coordinator

viva; United States; Remote; USD 44,000 - 64,000; Full time

Benefits offered by this job

Remote work

Job summary

Viva in the United States is seeking a Coordinator Risk Adjustment to support enterprise risk adjustment programs under the Manager, Risk Adjustment Coding Quality. The role involves routing records, coordinating provider chart requests, and ensuring timely delivery of materials while protecting PHI security.

You will organize documents, monitor emails, and run MS Excel/Access queries to track artifacts, serving as a key SME for Providers and Network Management.

Qualifications

• Minimum 3 to 5 years experience in Healthcare, Claims Processing, Administrative, Provider Relations and/or combination of experience.
• Highly organized with strong written and verbal communication skills.
• Proficient with MS Excel, MS Access and MS Word.
• Basic understanding of medical coding and health information data required.
• 1-2 year experience retrieving Medical Record from EMR preferred

Responsibilities

• Route records to appropriate resources and monitor progress through to resolution.
• Investigate non-participating provider chart requests and escalate as needed.
• Distribute documents and data files to providers and track delivery.
• Escalate issues to protect deliverables and due dates.
• Organize and coordinate production, distribution, storage and archiving of documents with PHI security in mind.
• Coordinate and schedule provider appointments for risk adjustment education and audits.
• Monitor central risk adjustment mailbox and route correspondence within the department.
• Run basic MS Access queries and MS Excel workbooks to monitor risk adjustment artifacts.
• Serve as Subject Matter Expert for Providers and Provider Network Management on risk adjustment applications and processes.
• Maintain knowledge of risk adjustment programs across supported lines of business and explore new EMR access.

Skills

Healthcare Experience

Claims Processing

Administrative Experience

Provider Relations

Managed Care

Medical Coding

Health Information Data

Retrieving Medical Records From EMR

Organizational Skills

Written Communication

Verbal Communication

Business Computer Programs

MS Excel

MS Access

MS Word

Education

High School/GED Required

Tools

MS Excel

MS Access

MS Word

Job description

Remote : Preferably EST, but open to other time zones besides PST.

Under the general direction of the Manager, Risk Adjustment Coding Quality, the Coordinator Risk Adjustment is responsible for supporting enterprise risk adjustment programs by completing the following duties:

• ensuring that records are routed to appropriate resources
• investigating all non-participating provider chart requests and escalating to appropriate resource as needed
• distributing related documents and data files to providers and monitoring through to resolution
• escalating issues in a timely manner to ensure deliverables and due dates are maintained
• Organize and coordinate the production, distribution, storage and archiving of documents and data files while maintaining Protected Health Information security protocols.
• Coordinate and schedule provider appointments to support risk adjustment education and audit reviews.
• Monitor central risk adjustment mailbox and route correspondence to appropriate associates within the department.
• Run and maintain basic MS Access queries and MS Excel workbooks to monitor risk adjustment related artifacts that support the program.
• Serve as Subject Matter Expert for Providers, Provider Network Management and other customers regarding risk adjustment programs and related applications (e.g., NaviNet, vendor chart retrieval application, etc.) by researching issues with internal process or vendor applications, interfacing with vendors as needed, and documenting/ delivering resolution
• Maintains a thorough knowledge of risk adjustment programs across all supported lines of business. Maintains and explores new provider EMR access for all LOBs
• Serves as point person for ordering, securing and maintaining departmental supplies.

Skills:

• Minimum 3 to 5 years experience in Healthcare, Claims Processing, Administrative, Provider Relations and/or combination of experience

Other Skills:

• Minimum of 3 years' experience in Claims, Managed Care and/or Healthcare environment with strong working knowledge of business computer programs, applications and systems required.
• Highly organized with strong written and verbal communication skills.
• Proficient with MS Excel, MS Access and MS Word.
• Basic understanding of medical coding and health information data required.
• 1-2 year experience retrieving Medical Record from EMR preferred

Education:

• High School/GED Required.

Skills:

• Required
• Healthcare Experience
• Claims Processing
• Administrative Experience
• Provider Relations
• Managed Care
• Additional
• Medical Coding
• Health Information Data
• Retrieving Medical Records From EMR
• Organizational Skills
• Written Communication
• Verbal Communication
• Business Computer Programs
• MS Excel
• MS Access
• MS Word

Notes:

Remote : Preferably EST, but open to other time zones besides PST.

40hrs/ week

VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status