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)
Your Role
The Risk Adjustment Provider Partnership team provides essential support to all functions within the risk adjustment program, which includes interaction with various cross-functional teams within Blue Shield and Provider Groups. The Risk Adjustment Consultant, Senior will report to the Manager, Risk Adjustment Provider Partnership. In this role, you will interface with Provider Group operational and clinical leadership to assist in identifying operational and clinical practices in maximizing recapture rates, understanding clinical suspects, and monitoring appropriate clinical documentation and accurate coding. The Risk Adjustment Consultant, Senior will also coordinate the implementation of Blue Shield Programs designed to ensure all diagnoses are coded according to CMS and risk adjustment coding guidelines and manage administrative projects within the Risk Adjustment Provider Partnership team. The ideal candidate possesses excellent customer service skills, project management skills, organizational skills, analytic skill, self-starter, and high attention to detail.
Your Work
In this role, you will:
At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in , Join us!
Your Knowledge and Experience
Pay Range:
The pay range for this role is: $ 96800.00 to $ 145200.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
About the Company:
Blue Shield of California
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