Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.
A day in the life: Can you see yourself building relationships with our network physicians? If the answer is yes then this could be the next step in your healthcare career!
Educate providers and office staff on clinical documentation/coding as part of office visits and develop working relationships to facilitate care gap closures.
Medical Records Auditor & Training Consultant (Medicare Risk Adjustment)
Location: May be remote, however, must be located in Louisville, KY or Sourthern Indiana (Jeffersonville/Clarksville). This work at home position requires approximately 75% local travel to provider offices within assigned territory in Kentucky (mileage reimbursed).
The Medical Records Auditor & Training Consultant performs audits by evaluating medical records to ensure risk mitigation and to ensure compliance with CMS, ICD-10-CM coding guidelines, and medical record documentation requirements. This position is also responsible for developing, reviewing, and/or presenting coding training materials where appropriate. Primary duties include:
- Collection and analysis of data to formulate recommendations and solutions based on audit trends and results.
- Provides regular feedback to leadership on performance improvement opportunities as a result of performance gaps.
- Serves as coding subject matter expert to internal and external stakeholders
- Provides education on coding for Medicare Risk Adjustment purposes through publications, presentations, etc.
- Assists the business with documentation of workflows and appropriate policies and procedures.
- Requires a Bachelor's degree or any combination of education and experience, which would provide an equivalent background.
- Requires a medical coding certification (e.g., Certified Coding Associate or Certified Professional Coder) from an accredited source (e.g., American Health Information Management Association or American Academy of Professional Coders).
- Must have experience and be comfortable conducting training or presentations to a small, medium, and large audience via web conference or face-to-face setting.
- Certified Risk Adjustment Coder - a plus.
- 5+ years of experience of relevant coding and/or medical record audit experience. Audit experience can be in a physician's office, hospital or insurance office setting.
- Experience developing educational materials is preferred.
- Medicare Risk Adjustment experience preferred.
- Proficient with MS Office applications: Word PowerPoint, Excel preferred.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.