Risk Adjustment Coordinator - San Diego (TEMP)
$43,680–$52,000 year
HybridCalifornia, United States or Orange, California, United States
Job Summary
Contact and collect medical records onsite from provider offices or via EMR access for coders, audits, and sweeps retrieval. Summarize meeting minutes, coordinate office activities including scheduling internal, external, and provider visits, and prepare weekly, monthly, or quarterly reports. Distribute E-Fax, respond to emails and faxes, and create/update monthly lists for active members and those without office visits in the IPA folder. Receive and organize data from external sources while maintaining HIPAA confidentiality and adhering to CMS Risk Adjustment standards. Attend provider and interdepartmental calls, promote positive relationships between NMM, IPAs, and the health plan, and participate in required IPA and health plan meetings. This temporary, full-time position supports the San Diego region with up to 50% travel and a hybrid work structure through October 2026.
Required Qualifications
- Must be able to travel up to 50% of work time
- High School diploma or GED
- Must value operating in a collaborative and cooperative environment
- Ability to show initiative, good judgement, and resourcefulness
- Excellent written and oral communication skills
- Strong interpersonal skills
- Excellent organizational, decision-making, and multi-tasking skills
- Excellent presentation, verbal and written communication skills
- Ability to collaborate with co-workers, senior leadership, and other management
- Proven ability to prioritize and organize multi-faceted/multiple responsibilities simultaneously in a fast paced, changing environment while meeting deadlines and turnaround time requirements
- Must be able to work independently utilizing all resources available while staying within the boundaries of duties
- Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information
- Proficient with Microsoft Office (Word, Excel, Power Point) and EZCAP
Desired Qualifications
- Must be able to work independently utilizing all resources available while staying within the boundaries of duties
- Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information
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