ACDI Risk Adjustment Support Specialists - Population Health

  • South Portland, ME
  • Maine Medical Partners
  • Full Time - Day Shift
  • Clerical/Administrative Support
  • Req #: 136261
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Summary

Position Summary
  • Under the general direction of the Senior Director of Population Health, this position works to support the overall goals of the organization’s ambulatory clinical documentation improvement program. In close collaboration with the Ambulatory CDI Specialist RN, the ACDI Risk Adj Support Spec performs retrospective and prospective chart review and reports on the accuracy and consistency of the data in accordance with accepted and established program standards.

    ACDI Support Specialists also coordinate and complete documentation requests from invested parties including Medicare Advantage Plans, MSSP, MHACO, and others. This may also include reviews of the medical record to identify and flag incomplete and/or inconsistent documentation that could impact resulting risk adjustment assignment.

    Other activities may include performing visit reminder outreach to patients when practices require such support.

Required Minimum Knowledge, Skills, and Abilities (KSAs)
  • Education: High school diploma or GED preferred. Associates degree or certified Medical Assistant strongly preferred.
  • License/Certifications: See "Education"
  • Experience: Three plus years’ experience in healthcare setting related to HCC Risk Adjustment and/or chart auditing. Experience in documentation review and auditing. Experience in Quality/HEDIS/gaps in care preferred.
  • Knowledge of Risk Adjustment methodology.
  • Effective problem solving, analytical skills and communication skills.
  • Demonstrated ability to work independently and as part of a Care Team.
  • Strong understanding of medical terminology.
  • Working knowledge of Microsoft Office suite.

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow. Our package includes health and dental insurances, paid parental leave, retirement program, generous paid time off, and much more! Our comprehensive array of benefits are competitive, affordable, and include choices that meet specific, but ever changing, needs.

MaineHealth is a not-for-profit integrated health system consisting of eight local hospital systems, a comprehensive behavioral healthcare network, diagnostic services, home health agencies, and over 19,000 employees. It is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.

With a career at any of the MaineHealth locations, you’ll be working with healthcare professionals that truly value the people around them – both within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the wellbeing of our communities and employees. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Our care – and the science behind that care – is top rate. Join us and your abilities will be challenged and enhanced as you take your career to another level.

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