What are the responsibilities and job description for the Risk Adjustment Specialist II position at Arizona Complete Health?
Transform the health of communities, one person at a time.
Job Description
This role has the potential to impact 28 million members, leveraging risk adjustment methodologies and managed care principles to drive provider performance.
Key Responsibilities
- Foster collaborative relationships with providers to enhance Risk Adjustment coding and documentation competencies.
- Develop and deliver training programs utilizing ICD10 guidelines to improve coding and medical record documentation.
- Analyze data trends using advanced Excel skills to identify barriers and develop strategies for engagement.
- Collaborate with health plan teams to create educational materials and facilitate webinars and trainings.
- Apply clinical coding knowledge to review claims and medical records for accurate documentation and coding.
- Exercise independent critical thinking and decision-making skills to support providers with inquiries and challenges.
Requirements
Bachelor's Degree in Health Promotion, Public Health, or related field required. 3 years equivalent experience in Health Insurance, Customer Service, Claims, or Provider Office required. Knowledge of healthcare, managed care, and Risk adjustment methodologies is highly preferred.
Work Environment
This position involves travel to areas surrounding Tempe and Tucson, Arizona (20% in-state travel required). Competitive benefits package including competitive pay, health insurance, 401K, tuition reimbursement, paid time off, and flexible work arrangements.
