Risk Adjustment Coding Analyst

Centene

Job Details

Location: Charlotte, Mecklenburg County, North Carolina, USA Posted: Nov 08, 2019

Job Description

Position Purpose: Audit vendor and internal risk adjustments coding to ensure accuracy and identify and mitigate any risks.

Validate provider, vendor, and internal diagnosis coding for accuracy by reviewing and analyzing samples of coding and claims extract compared to actual medical records

Review and identify trends in coding discrepancies and notify applicable department for potential training and education

Determine coding issues and discrepancies and make updates as necessary

Identify issues, determine impact to risk adjustment models and reports results for various products and services

Coordinate delete files with leadership from Medicaid, Medicare, and Marketplace and Encounters department

About Centene

Centene is a multi-line health care enterprise offering Medicaid managed care and specialty services.

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