Adjustment Clerk reviews and follows up on customer complaints regarding account balances and uncredited items. Analyzes associated documents and makes necessary adjustments to accounts and/or recommendations to resolve customer issues. Being an Adjustment Clerk communicates results of findings to customer. Requires a high school diploma or its equivalent. Additionally, Adjustment Clerk typically reports to a supervisor or manager. The Adjustment Clerk possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Job Summary: This position focuses on all CMS submission related operations in support of Prominence Health Plan's Medicare Advantage business. Activities include creating submission files related to chart retrievals per vendor proprietary format, perform data analysis in support of optimizing risk adjusted revenue, maintain compliance with all CMS standards related to health plan submissions, and modeling the financial impacts of changes in risk adjustment data and methodologies. This position will work with multiple internal departments, maintaining tracking documentation to ensure closure of gaps and resolution of data errors. Assist in reporting current KPIs and create new reports to appropriately track ROIs.
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0 Adjustment Clerk jobs found in Reno, NV area