Centene Corporation · 1 hour ago
Senior Compliance Risk Adjustment Analyst
United States
Full-time
Remote
Mid, Senior Level
$69K/yr - $124K/yr
3+ years expCentene Corporation is transforming the health of our communities, one person at a time. The Senior Compliance Risk Adjustment Analyst supports the Risk Adjustment Compliance program by managing external audits and ensuring compliance with regulatory standards.
Hospital & Health Care
Responsibilities
Serves as the point of contact for external audits, and correspond with auditors related to audit acknowledgement, deliverables timelines and other inquiries
Manages external audit deliverables submission responsibilities and responds to inquiries from state and federal regulatory agencies timely
Quality Review all external audit deliverables for completeness and accuracy prior to submission to external auditors
Communicates with both internal and external audit partners to clarify deliverables, audit requirements and deadlines
Serves as a risk adjustment external audit resource and liaison on external audit policies, communications, external audit workflow, and quality improvements initiatives
Socializes identified risks with internal partners including the Compliance Corrections team by timely entering Corrective Action Intake
Supports the Corrective Action Plan development and reviews prior to submission to the external auditors
Effectively creates and communicates audit milestone progress reporting
Maintains detailed audit documentation including meeting minutes, action items, identified issues, and risk management plans
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Bachelor's Degree Audit, Compliance, Legal or related field; or equivalent experience
3+ years Audit, risk adjustment and/or compliance
Risk Adjustment/HCC coding
Medicare experience
Active Coding Credential from AHIMA or AAPC
Preferred
Demonstrated understanding of risk adjustment regulatory landscape
Risk Adjustment regulatory audit experience
CPMA, RHIA, RHIT or Risk Adjustment Credential
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Beth Johnson
President and CEO, Coordinated Care
Clyde White
President & CEO (New Hampshire Healthy Families)
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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