Risk Adjustment Provider Engagement Lead - (San Jose, CA)

Job details: Responsible for building relationships with our external physicians while conducting medical record reviews, monitoring and analyzing coding patterns, and providing onsite education. Provide coding ability as well as administrative oversight to improve the overall quality of the documentation; ensuring that it is to the highest level of specificity in accordance to the CMS guidelines. General Duties/Responsibilities: Validate provider documentation for accuracy by reviewing and analyzing samples of coding and claims extracts compared to actual medical records. Track and report progress of the chart reviews performed on the external physicians to assure the coding accuracy and quality of the data submitted to CMS is accurate to the highest level of specificity. Develop education materials to assist physicians in accurately assessing patients' overall health status.