Adjustment Clerk reviews and follows up on customer complaints regarding account balances and uncredited items. Analyzes associated documents and makes necessary adjustments to accounts and/or recommendations to resolve customer issues. Being an Adjustment Clerk communicates results of findings to customer. Requires a high school diploma or its equivalent. Additionally, Adjustment Clerk typically reports to a supervisor or manager. The Adjustment Clerk possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Job Description
ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans – powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began. It’s a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
Position Description
As the Risk Adjustment Oversight Lead, you will be responsible to develop, enhance, communicate and lead UCare's Risk Adjustment Oversight Program. UCare's Oversight Program is accountable to manage all facets of UCare's Risk Adjustment activities as it relates to data submissions to government agencies for risk adjustment payments based on diagnoses that are compliant with applicable laws, regulations and contractual requirements. You will work with the Audit Director to ensure UCare has effective program elements such as: policies & procedures, training & education, risk assessment, audit & monitoring, responding to detected offenses, developing corrective action initiatives, and effective lines of communication with the Compliance Officer and Disclosure Program.
Requirements
Education
Bachelor’s degree demonstrated experience may be considered in lieu of degree. Current and valid professional coding certification from an accredited institution.
Required Experience
Three years of progressive coding experience using ICD-9/ICD-10-CM, CPT and HCPCS. Three years of experience with risk adjustment coding (HCC). At least one year of coding, billing and compliance experience across a broad range of specialties and working with Medicare coding requirements. Experience in conducting audits and medical record reviews.
Preferred Experience
Experience with Data Validation audits. Clinical coding experience. Certified Risk Adjustment Coder (CRC)
THE UCARE DIFFERENCE
The UCare difference is our people power – employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to .
Clear All
0 Adjustment Clerk jobs found in Minneapolis, MN area