Utility Adjustment Analyst Jobs

Responsible for team assignments, workload, and performance management

Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.

6+ years, of experience in managed care or the health care industry

Manages the coding program in the market regardless of whether coders are agilon badged or leased from provider groups

Bachelor’s degree: or equivalent work experience required.

Accountable for the hiring and onboarding of all new Risk Adjustment team members (reviewers, coders, coordinators, etc.)

Proven superior customer/consultant relationship management and collaboration skills

Provides business analysis support to the project management function from initiation through delivery in alignment with client expectations and business needs

Demonstrated solid leadership skills with proven ability to foster and manage senior-level relationships in a highly matrixed environment

Proven ability to influence with and without direct management/authority

Proven ability to manage medium sized teams across remote locations

Receives a moderate level of guidance and direction and uses previous experience to identify solutions

Working experience of Microsoft applications (PowerPoint, Excel, and Visio)

Working experience with SQL required

Experience with Power BI required

Experience with Tableau or other data visualization software programs preferred

Excellent oral/written communication skills required

Medicare HCC Risk Mitigation efforts

Minimum one (1) year experience in CMS HCC risk adjustment coding preferred

Successful completion of coding certification program (CCS,CPC, CRC, or RHIT through AHIMA/AAPC)

Will need to be well grounded in sound medical coding practices. Knowledge of HEDIS data collection is required

Excellent written and oral communication skills

Experience with NCQA HEDIS programs and data collection preferred

High School Diploma, GED or equivalent required

Assist with following up on outstanding disputes that have not been acknowledged by the vendors with smaller expense profiles.

Associate or Bachelor’s Degree, preferably in Finance, Accounting, Economics, Math or Statistics.

Experience with MS Outlook, MS Excel, & MS Word.

Update the internal system with proper credits. It is important to be accurate in this activity

Previous work in a utility environment or A/P environment is helpful.