Franciscan Alliance, Inc. logo
Franciscan Alliance, Inc.

Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.

Risk Adjustment Auditor

Location

Indiana

Posted

83 days ago

Salary

$19 - $29 / hour

Seniority

Mid Level

Associate's Degree

Job Description

Risk Adjustment Auditor

Franciscan Alliance, Inc.

Role Description As a MARSI (Medical Audit, Recovery & Strategic Health Initiative) certified auditor, it will be critical to review medical records to accurately identify diagnosis and codes based on pre-visit services. The auditor's role will include: - Reviewing HCC and RAF problem lists on a pre-visit basis. - Reviewing HCC gaps for the year. - Providing solutions to increase provider documentation and capture diagnosis codes that weren’t captured during the visit. - Ensuring all members of the clinical team are aware of patients with HCC Gaps to alert their provider. - Ensuring these patients have a scheduled follow-up appointment with their attributed primary care physician/NP/PA. Qualifications - Associate's Degree, LPN/RN - Required - Certificate, Medical Assisting - Required - 3 years experience in the Medical Field - Required - 1 year Coding experience - Preferred - Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) - Required - Licensed Practical Nurse (LPN) - State Licensing Board - Required - Registered Nurse (RN) - State Licensing Board - Required Requirements - Attention to detail while reviewing patient’s clinical record. - Ensure regulatory compliance, and overall quality and efficiency by utilizing strong working knowledge of coding standards and EPIC. Benefits - Comprehensive benefit offerings for eligible employees. - Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

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