InnovaCare Health

• Review patient medical records (charts) for completeness, accuracy, and compliance with ICD-10-CM coding guidelines and CMS risk adjustment criteria • Identify documentation gaps or opportunities that impact HCC capture and risk scores • Utilize AI-enabled CDI platforms, electronic health records (EHR), and data dashboards to analyze trends, prioritize chart reviews, and flag discrepancies • Work closely with primary care providers, specialists, and other clinical staff to clarify documentation and educate on best practices, when required • Collaborate with coding, billing, compliance, and analytics teams to align goals and implement CDI strategies, when required • Support the execution of cross-functional projects aimed at improving data integrity, documentation quality, and risk adjustment outcomes • Maintain accurate tracking and reporting of CDI queries, provider responses, and documentation improvements in designated systems or databases • Stay up to date on current CMS guidelines, ICD-10-CM updates, HCC risk adjustment models (CMS-HCC, RxHCC), and relevant healthcare regulations

• Review patient medical records (charts) for completeness, accuracy, and compliance with ICD-10-CM coding guidelines and CMS risk adjustment criteria. • Identify documentation gaps or opportunities that impact HCC capture and risk scores. • Utilize AI-enabled CDI platforms, electronic health records (EHR), and data dashboards to analyze trends, prioritize chart reviews, and flag discrepancies. • Work closely with primary care providers, specialists, and other clinical staff to clarify documentation and educate on best practices, when required. • Collaborate with coding, billing, compliance, and analytics teams to align goals and implement CDI strategies, when required. • Support the execution of cross-functional projects aimed at improving data integrity, documentation quality, and risk adjustment outcomes. • Maintain accurate tracking and reporting of CDI queries, provider responses, and documentation improvements in designated systems or databases. • Stay up to date on current CMS guidelines, ICD-10-CM updates, HCC risk adjustment models (CMS-HCC, RxHCC), and relevant healthcare regulations.

• Own enterprise contact center performance across all markets and channels • Establish KPI targets and monitor performance • Lead team of managers and ensure operational accountability • Build and maintain contact center improvement roadmaps • Facilitate quarterly communication across teams