POSITION SUMMARY:

Responsible for reconciling Financial, Enrollment and Special Status discrepancies for FHCP Medicare Advantage members. Will assist Risk Adjustment Operations Supervisor or designee with issues related to Software vendor and other financial reporting functions. Responsible for assisting with data collection and analysis for audit projects for both Medicare and Commercial Risk Adjustment. Responsible for monthly Risk Adjustment reporting creation and validation, for both internal and external reporting needs.

QUALIFICATIONS:

Education, skills and experience:

• Associate’s degree or higher required.


• Minimum one-year previous financial auditing experience required.


• AAPC coding certification required within one year of hire date. 


• Excellent organizational, analytical, verbal, and written communication skills required. 


• Strong computer skills including Excel required.


• Knowledge of medical terminology, ICD-10/CPT/HCPCS coding, and medical record documentation preferred.


• Must have a valid Florida driver’s license and reliable transportation.