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Rutland Regional Medical Center

Rutland, Vermont

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Community Care of North Carolina Inc

Cary, North Carolina

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Salt River Pima-Maricopa Indian Community

Scottdale, Arizona

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Mount Sinai Health System

New York, New York

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Mount Sinai Health System

New York, New York

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ISMIE Mutual Insurance Company

Chicago, Illinois

Cincinnati Children's Hospital Medical Center - Cincinnati, OH

Cincinnati, Ohio

BETA Healthcare Group

alamo, California

Healthcare Education Insurance Company

Gainesville, Florida

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Ann & Robert H. Lurie Children’s Hospital of Chicago

Chicago, Illinois

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AdventHealth

Nationwide

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Phoenix Children's

Phoenix, Arizona

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AdventHealth

Shawnee Mission, Kansas

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AdventHealth

Altamonte Springs, Florida

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AdventHealth

Orlando, Florida

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Phoenix Children's

Phoenix, Arizona

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ChristianaCare Health System

Wilmington, Delaware

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CHRISTUS Health

Tyler, Texas

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AdventHealth

Sebring, Florida

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WMCHealth

Poughkeepsie, New York

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Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio

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Harris Health System

Houston, Texas

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AdventHealth

Hinsdale, Illinois

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UNM Hospital

Albuquerque, New Mexico

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Risk Adjustment Auditor 1
JOB SUMMARYAccountable for reviewing member records to accurately maximize risk scoring in keeping with Baylor Scott and White Health risk adjustment strategies and processes for lines of business subject to risk adjustment.ESSENTIAL FUNCTIONS OF THE ROLEConducts provider audits and creates provider scorecards to offer feedback on Risk Adjustment MethodologyInterprets health record documentation to code and abstracts diagnoses and/or procedures for inpatient, outpatient, and clinic casesConducts focused HCC reviews on providers and clinics, tracks results and identifies trends and deficiencies for follow-upResearches complex coding HCC issues and keeps abreast of coding and compliance changes as commu


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