| Risk Adjustment Data Analyst III Job Description |
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| The following is a full job description for Risk Adjustment Data Analyst III. Here are the requirements and responsibilities for Risk Adjustment Data Analyst III along with statistics. If after reading this page you determine that Risk Adjustment Data Analyst III is not the position you are looking for, you may want to try one of these similar titles: Risk Adjustment Data Analyst II, Risk Adjustment Data Analyst I, Risk Adjustment Data Analysis Director, Risk Modeling Analyst III, Data Analyst III, Insurance Risk Analyst III, Risk Analyst III, VP of Risk Adjustment Data Analysis, Risk Adjustment Data Analysis Manager |
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| Requirements and Responsibilities For Risk Adjustment Data Analyst III |
| Analyzes healthcare data to assess patient risk scores and ensure accurate reimbursement calculations. Utilizes patient health factors, their likely use of health care services, and the costs of those services to calculate payment adjustments, forecast revenue impacts, and identify coding gaps. Reviews medical claims, encounter data, and electronic health records to ensure proper coding of diagnoses and accurate reporting to government healthcare programs. Prepares reports on risk adjustment performance and recommends strategies to optimize financial performance while maintaining regulatory compliance. Supports audits and data validation activities to ensure compliance with risk adjustment program requirements. Requires a bachelor's degree. Typically reports to a manager. Work is generally independent and collaborative in nature. Contributes to moderately complex aspects of a project. Typically requires 4-7 years of related experience. |
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| Also referred to as: Health Risk Adjustment Analyst III, Insurance Risk Adjustment Analyst III, Insurance Risk Rating Analyst III |
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| Similar Jobs: Risk Adjustment Data Analyst II, Risk Adjustment Data Analyst I, Risk Adjustment Data Analysis Director, Risk Modeling Analyst III, Data Analyst III, Insurance Risk Analyst III, Risk Analyst III, VP of Risk Adjustment Data Analysis, Risk Adjustment Data Analysis Manager |
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| Level of Education: Risk Adjustment Data Analyst III Salaries with No Diploma, Risk Adjustment Data Analyst III Salaries with a High School Diploma or Technical Certificate, Risk Adjustment Data Analyst III Salaries with an Associate's Degree, Risk Adjustment Data Analyst III Salaries with a Bachelor's Degree, Risk Adjustment Data Analyst III Salaries with a Master's Degree or MBA, Risk Adjustment Data Analyst III Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Edu., Gov't. & Nonprofit, Financial Services, Healthcare, Insurance | |
