RRemoteville
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Risk Adjustment Revenue Cycle Analysis and Solutions

Skills
ActingAnalytical SkillsClient VisitsContent Management SystemsCustomer Relationship ManagementHealth InsurancePresentation Skills
Role

What the job involves

The main requirements, responsibilities and hiring steps.

Requirements

  • Associate degree required
  • Minimum 3 years experience in HCC or risk adjustment
  • Required experience with risk adjustment analytics strongly preferred
  • Knowledge of CMS Medicare revenue cycle in risk adjustment payment model preferred
  • Proficiency with MS Word Excel and PowerPoint
  • Strong written and verbal communication skills
  • Ability to prioritize and coordinate work activities
  • Excellent presentation skills
  • Ability to manage multiple complex tasks
  • Detail oriented with ability to work independently and follow instructions
  • Comfort working with highly confidential information under HIPAA
  • Ability to work in a fast paced rapidly changing environment
  • Willingness to commute to multiple site locations within assigned territory and work extended hours as needed

Nice to have

  • Initiative
  • Follow-through
  • Detail-oriented
  • Independent
  • Confidentiality
  • Adaptable

Day to day

  • Assess Medicare revenue cycle data for assigned PACE programs using CMS returns files and internal analytics to identify variances, risks, and required actions.
  • Partner closely with client financial teams and Capstone colleagues to support accurate premium payments, strengthen relationships, and coordinate onboarding and service improvements.
  • Deliver quarterly reviews, client visits, webinars, training, schedule management, and issue resolution while maintaining HIPAA compliance and high customer satisfaction.