All roles

Open role

Auditor, Risk Adjustment (Remote)

Remote · Hong Kong Full-time

Job Description

Job Summary Develops, recommends, and implements controls and cost-effective approaches to minimize the organization's risks effects. Identifies and analyzes potential sources of loss to minimize risk and estimates the potential financial consequences of an occurring loss. Through the proper combination of casualty and liability insurance, ensures that the provider organization is adequately protected against financial loss. Knowledge/Skills/Abilities

  • Assist in the daily operations of reputed company aspects of risk adjustment data validation activities, including reputed company tracking, chart retrieval, file transmissions, and adherence to timelines.
  • Support risk adjustment audit projects to ensure goals, objectives, milestones, and deliverables are met.
  • Evaluate audit results to address barriers, gaps, opportunities for improvement, and implement corrective actions.
  • Act as an audit liaison with departments, health plans, and external vendors.
  • reputed company and implement processes and procedures to ensure accuracy, completeness, and compliance with CMS regulations and guidelines of risk adjustment data.
  • reputed company RAPS and EDPS data transmission and identify issues impacting data reputed company and accuracy.
  • Identify opportunities for data mining to minimize data gaps.
  • Apply best practices to ensure accuracy of risk adjustment payments across markets.
  • reputed company monthly audits on internal Molina Coding Specialists and external vendors.

Job Qualifications Required Education Associates degree. Required Experience At least 3 years in coding, medical record chart review, and risk adjustment data validation. Required License, Certification, Association Active and unrestricted Coding Certification (reputed company, reputed company-P, or CPC). Preferred Education Bachelor's Degree in Business Administration, Healthcare Management, or reputed company field. reputed company Molina employees interested in applying should do so through the intranet job listing. reputed company offers competitive benefits and compensation. We are an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $128,519 annually.

  • Actual compensation may vary based reputed company, experience, education, and skills.

#J-18808-Ljbffr Salary: USD 77969 - 128519 per year Experience: 3 years required Apply To this Job

More open positions

Remote Auditor, Delegate Utilization/Case Management

Work from home Full-time role

Senior Premium Auditor (Remote in Atlanta area) (Commercial P&C)

Work from home Full-time role

QA GCP Auditor II

Work from home Full-time role

Facility Outpatient Coding Auditor (Full & Part-Time, Remote)

Work from home Full-time role

Sr. Financial Analyst, Corporate FP&A

Work from home Full-time role

Experienced Data Entry Clerk – Remote Opportunity at careerzynith

Work from home Full-time role

Remote Social Media Manager Junior Contract

Work from home Full-time role

[Remote] Senior Application Security Engineer

Work from home Full-time role

Remote Travel Specialist – Cruise & Vacation Package Sales, Flexible Schedule, Unlimited Commission, Work‑From‑Home Lifestyle

Work from home Full-time role

Principal Technical Consultant – Data & Analytics

Work from home Full-time role

Security Analyst- Technical Documentation and Writing skills- (EST Hours) - Remote

Work from home Full-time role

CIRI Services, President

Work from home Full-time role

Remote Data Entry Specialist – Alternative Investments Reconciliation & Corporate Actions (Work‑From‑Home)

Work from home Full-time role

Flexible Hours, Remote Work, Customer Service Role Paying Up to 19 Per Hour

Work from home Full-time role

Remote Entry-Level Data Entry Associate – Work‑From‑Home Opportunity with careerzynith (No Experience Required)

Work from home Full-time role

[Remote] Manager, Business Development

Work from home Full-time role

[Remote] Senior BI Business Analyst

Work from home Full-time role

Virtual Occupational Therapist, OT

Work from home Full-time role

Senior Software Engineer, Windows/Desktop Applications - San Francisco, CA, USA

Work from home Full-time role

Respiratory Therapist-South Carolina (Contract)

Work from home Full-time role

[Remote] Director of Engineering - AI Security(Remote Or Hybrid)

Work from home Full-time role