Risk Adjustment QA Analyst

Position Title - Risk Adjustment QA Analyst

Essential Functions:

• Completes overread of chases for coders in production and provides support in

completing initial QA process during onboarding.

• Communicates with and provides feedback to the Training and QA team of coding error

trends and assist in creating action plans to mitigate QA discrepancies.

• Assists coders in resolving coding queries based on Reveleer Coding Guidelines, AHA

Coding Clinics, CMS Coders Guidance on Medical Review.

• Create and maintain quality control activities: Bi-monthly quality check on performance,

monthly quality assurance reviews, keeping track of QA scores and make sure that all

corrections are done in a timely manner.

• During the bi-monthly quality checks – able to identify outliers that needs retraining and

set action plans and communicated either on one-on-one or group teaching in

coordination with the training team.

• Pulls reports to better understand error trends and present to internal team for

deliberation.

• Collaborate and consult effectively with all levels of the QA teams to ensure adherence

to policies and procedures.

• Well-versed and Knowledgeable on Microsoft Office applications (Excel, Word,

Powerpoint) as well as Adobe Pro and use these applications to handle communication

within the clinical team.

REVELEER DIGITAL SOLUTIONS INDIA PRIVATE LIMITED

J O B P O S T I N G

• Additional duties as necessary to meet our obligations to our customers.

Core Competencies:

• Caring – Warm, sincere, calm, cool and collected energy and presence with the ability to

develop relationships.

• Analytical Skills and Attention to Detail– Reviewing clinical documentation and coding.

• Effectively Communicates – Speaks clearly, listens effectively, and responds well to

questions; Writes clearly and informatively; Edits work for errors; Varies writing style to

meet needs; Able to read and interpret information; Documents are accurate and

delivered on time; Uses good judgement when communicating information.

• Interpersonal Skills - Builds strong relationships; Flexible and open minded; Receptive to

feedback; Motivates employees and peers for the purpose of achieving organizational

goals.

• Professionalism – Approaches others in a tactful manner; Reacts well under pressure;

Treats others with respect and consideration regardless of their status or position;

Accepts responsibility for own actions; Follows through on commitments.

• Adaptability – Adapts to changes in the work environment; Adjusts methods to best fit

the situation; Able to deal with change, delays, or unexpected events. Can work with

diverse groups of customers and internal stakeholders.

• Cultural Sensitivity – Models behaviors that reflect the culture of Reveleer; Awareness

of the similarities and differences that exist between employees, teams, departments,

and customers to build more effective relationships.

• Computer Skills – Essential to be skilled in with all Microsoft Suite products (e.g., Excel,

Word, PowerPoint, etc.)

Job Requirements:

• Must have a professional coding certificate through AHIMA/AAPC

• Minimum of 5 years coding experience with specific knowledge of Medicare and

Commercial Risk Adjustment such as Hierarchical Condition category (HCC)

• Strong computer skills and high-speed internet access at home

• Commitment to confidentiality of patient health information

• Professional, articulate and able to work independently

Reveleer is an equal opportunity employer. We do not discriminate on the basis of race, religion,

color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran

status, disability status or genetic information, in compliance with applicable federal, state and

local law.