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Risk Adjustment Audit/Ed/Training Consultant (PS21740 KT)

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Job Details
Job Order Number
Company Name
Anthem, Inc
Physical Address

Topeka, KS 66612
Job Description

Risk Adjustment Audit/Ed/Training Consultant (PS21740 KT)

Location: United States

Requisition #: PS21740

Post Date: Jun 06, 2019

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health benefits companies and a Fortune Top 50 Company.

Risk Adj Audit/Ed/Training Consultant

Responsible for ensuring complete risk scores and accurate revenue and mitigating payment error risk via auditing, education, and training for proper diagnosis coding and documentation practices.

Primary duties may include, but are not limited to:

Identifies opportunities to improve accuracy and completeness for revenue impact.

Translates data to provide answers for provider consultations in order to improve medical record documentation and risk scores.

Provides feedback to providers on performance improvement opportunities; tracks and prioritizes projects to improve coding and documentation outcomes.

Develops and implements action plans to address issues identified through data analysis.

Provides oversight, guidance, and training to partner providers and clinicians related to CMS guidelines and HCC best practices.

Develops training programs and tools; performs internal process and policy audits.

This position can be located at any Anthem locations listed below (No relocation assistance is available)

220 Virginia Avenue Indianapolis, Indiana

4425 Corporation Way, Virginia Beach VA

3350 Peachtree Road NE Atlanta, Georgia

4361 Irwin Simpson Road (Bldg. I) Mason, Ohio

2015 Staples Mill Rd. Richmond, VA 23230

2 Prestige Place, Suite 400 Miamisburg, Ohio, 45342

4200 West Cypress Street Suite 900 Tampa, FL 33607

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.


BA/BS in health sciences, health management, or nursing;

6 years of experience in healthcare including provider relationship management, ICD-10coding, and experience in a consultativeor teaching role,

3 years of CMS Risk Adjustment experience

or any combination of education and experience, which would provide an equivalent background.

CPC,CCS,RHIT or CRCfrom accredited source(e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) or equivalent certification required.

Experience developing training programs and provider tools required.

Proficiency in MS office, developing coding curriculum and distance education techniques


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