Adjustment Clerk jobs in Medford, OR

This position is located in Klamath Falls, Oregon and is a hybrid remote position.

This position is responsible for member outreach, department administrative coordination, and applicable data capture related to the risk adjustment program. This position will perform In Home Evaluation (IHE)/Comprehensive Annual Visit (CAV) outreach calls to members, outreach to facilities and clinics for documentation requests, and provide technical assistance to internal and external parties by performing the following duties.

JOB DUTIES

• Performs member outreach for IHE/CAV scheduling and coordination.
• Assists providers with prospective chart review by providing previous encounter data and documentation in the appropriate format.
• Submits record requests and performs follow up with clinics and providers as part of risk adjustment chart review and audits.
• Assists on complex risk adjustment audits under the direction of the Risk Adjustment Manager while adhering to schedules and deadlines.
• Serves as liaison between risk adjustment department and external partners assisting with all aspects of documentation completion and submission to CMS.
• Coordinates onsite visits and audits between clinics and the Risk Adjustment Manager and/or Risk Adjustment Auditor.
• Performs data entry into various systems.
• Collects, organizes, and shares data with internal and external partners as directed.
• Prepares various documents and reports related to risk adjustment.
• Attends, schedules, and/or facilitates meetings as needed.
• Maintains confidentiality and complies with HIPAA rules and regulations.
• Maintains punctual, regular, and predictable attendance.
• Works collaboratively in a team environment with a spirit of cooperation.
• Displays excellent communication skills required in working with members and coworkers and including the ability to communicate effectively and remain calm and courteous under pressure.

Bilingual (Spanish/English) is preferred.

EDUCATION and/or EXPERIENCE

Associate’s degree from two-year college or university and one to three years related experience and/or training; or equivalent combination of education and experience.

COMPUTER SKILLS

Has advanced basic computer job skills including logging on to systems, ability to communicate by email, ability to compose documents, enter database information, create presentations, download forms, and preserve/backup important data.

We provide a competitive salary and excellent benefits, including vacation, medical, dental and vision insurance, and 401(k) pension plan. To apply for this position, please submit a cover letter and resume. We are an Equal Opportunity Employer.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: Hybrid remote in Klamath Falls, OR 97601