Adjustment Clerk reviews and follows up on customer complaints regarding account balances and uncredited items. Analyzes associated documents and makes necessary adjustments to accounts and/or recommendations to resolve customer issues. Being an Adjustment Clerk communicates results of findings to customer. Requires a high school diploma or its equivalent. Additionally, Adjustment Clerk typically reports to a supervisor or manager. The Adjustment Clerk possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Description
Primarily responsible for overseeing and facilitating quality assurance audits for providers and internal coders. The audits will be used to set department goals and objectives, to identify deficiencies or process improvements, and to ensure compliance with state and federal guidelines. Focus will include the review of HEDIS performance measures and ensuring submitted conditions are fully supported by clinical documentation and are being coding to the highest specificity and accuracy. As part of the population health team the HCC Risk Adjustment Coder will work in different capacities within the department to assist with establishing accurate risk scores for our patients.
Requirements
Required Education, Knowledge & Experience:
Physical & Mental Requirements:
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