About the role

Risk Adjustment Coordinator at Astrana Health focusing on medical records and provider communication. Coordinating office activities and ensuring compliance with HIPAA and CMS standards.

Responsibilities

Contact and collect medical records onsite from Provider’s offices or via EMR access documentation for coders/audits/sweeps retrieval
Collect and summarize meeting minutes from the meeting.
Coordinate office activities (such as scheduling meeting for internal/external and provider visit)
Prepare reports for the meeting (weekly/monthly or quarterly, if needed)
Distribute E-Fax
Responding to emails and faxes specifically to the team
Create/update monthly list for Active Members/Member Without Office Visit in IPA folder.
Receive and organize data from external sources.
Understand the principles of HIPAA and maintain confidentiality of patient health information.
Understand the principles of Risk Adjustment based CMS standards.
Communicate internally and externally as needed to gather necessary data.
Attend provider and interdepartmental calls in accordance with exceptional customer service.
Promotes a positive working relationship between NMM, IPAs, and health plan.
Attend IPA and health plan meetings as required and respond to questions/inquiries in a timely manner.
Performs duties in a professional manner, utilizing time and resources efficiently.

Must be able to travel up to 50% of work time.
High School diploma or GED required.
Must value operating in a collaborative and cooperative environment.
Ability to show initiative, good judgement, and resourcefulness.
Excellent written and oral communication skills, as well as strong interpersonal.
Excellent organizational, decision-making, and multi-tasking skills.
Excellent presentation, verbal and written communication skills and ability to collaborate with co-workers, senior leadership, and other management.
Proven ability to prioritize and organize multi-faceted/multiple responsibilities simultaneously in a fast paced, changing environment while meeting deadlines and turnaround time requirements.
Must be able to work independently utilizing all resources available while staying within the boundaries of duties.
Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.
Proficient with Microsoft Office (Word, Excel, Power Point) and EZCAP.

The national target pay range for this role is $20 - $26 per hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
This role follows a hybrid work structure where the expectation is to work at home on a daily basis, with travel up to 50% of the time as needed in the surrounding areas.
The work hours are Monday through Friday, standard business hours.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.