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
The healthcare system isn’t designed for health. We’re designed to change that.
We’re Wellvana, and we help doctors deliver life-changing healthcare.
Through our elevated value-based care programs, we’re revitalizing an antiquated system that’s far too long relied on misaligned incentives that reward quantity of care not the quality of it.
Our enlightened approach—covering everything from care coordination to coding to marketing— ties the healthy outcomes of patients directly to healthier earnings for primary care providers.
Providers in our curated network keep their independence, reduce their administrative headaches, and spend more time with patients. Patients, in turn, get an elevated experience with coordinated 24/7 care that is nothing short of life changing.
Recently named by Insider as one of 33 startups “investors expect to take off in 2023,” we’re one of the fastest-growing healthcare companies in America because what we do works.
This is the way medicine is meant to be.
The Role:
The Risk Adjustment Provider Educator educates Providers on all aspects of risk adjustment coding, regulatory requirements, and proper documentation procedures for MA, MSSP, ACO Reach, DCE patients. Identify coding trends and documentation patterns from data retrieved by coding reviews and audits, tailoring education accordingly. Educator must have a thorough understanding of the purpose of risk adjustment coding and HCC Risk Adjustment Model Categorical Hierarchy and be able to communicate this knowledge effectively to Providers. Follow-up educations and coding improvement tracking. Distribution of any training materials needed. Knowledge of how to identify unreported conditions and instruct providers how to readdress open chronic conditions. Responsible for building positive relationships with assigned Physicians and serve as a contact for any questions or concerns that may arise. Identify those Practices that need initial or ongoing additional training. Must be proficient at Prospective, Retrospective and Concurrent review processes. Reports directly to Director of Auditing. This position does require the ability to have reliable transportation in order to conduct ongoing face-to-face interactions with Providers. Educator will be required to frequently travel to regional offices.
Responsibilities:
Requirements
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