Reli Group

• Conduct auditing and monitoring activities in support of innovative healthcare models • Support the development of Excel based trackers • Draft, update, and review task specific reports, templates, and procedure documents • Support Project Management Office team with project level services

• Perform diagnosis coding of inpatient, outpatient, and physician office medical records • Record all process information in system in accordance with contract and organizational guidelines • Review feedback from Senior Coders to improve accuracy and quality of work • Maintain security and confidentiality of medical records and Protected Health Information (PHI)

• Assist in the internal Quality Audits to maintain our ISO and CMMI certifications • Analyze existing processes, identify gaps, and implement process improvements • Collaborate with Shared Services teams across the enterprise to create an AI-driven Compliance Matrix Dashboard in SharePoint • Assist in Program Management document creation and maintenance of the Process Asset Library (PAL)

• Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. • Perform intake validity checks on each medical record submitted. • Perform Medical Record Dispute and Appeal reviews. • Provide Appeals support as RADV Subject Matter Expert at CMS request. • Participate and contribute to QA Panel discussions for medical record review intake/coding and appeals. • Interact with the physician reviewer(s) as required. • Accurately enter data into encoder, system, and other as required software using a personal computer, keyboard and/or mouse. • Consistently meet or exceed productivity and accuracy standards of 95% minimum IRR established by the customer and/or the company.