Audit Specialist / Trainer - Cognisight
Company: Rochester General Health System
Posted on: June 7, 2021
Provide overall audit support with duties that include, but are
not limited to:
- Proficiency in health plan Demographic and Enrollment and RXC
systems and workflows.
- Ability to work in a fast paced, complex organization, with
regulated deadlines while providing effective audit support to
- Develop and maintain excellent relationships; internally within
team setting and externally, across large client base.
- Accountable for performing critical Demographic and Enrollment
and RXC audit function with strong attention to detail and 100%
accuracy, while navigating multiple client Enrollment and RXC
- Create and maintain documentation in support of CMS mandated
audit of health insurance plans' demographic and claims
- Obtains relevant information towards finalizing deliverables
based on client input and requirements from CMS documentation.
- Own client audit statuses and provide accurate updates, gap
discovery and closure planning to Account Management and
- Creates, delivers client presentations relative to Demographic
and Enrollment and RXC Data Validation Audit training, regulations,
guidelines and client results.
- Staying apprised of the Department of Health and Human Services
(HHS) regulations and guidelines relative to Demographic and
Enrollment and RXC Data Validation Audits.
- At least 30% of job position responsibility to include
face-to-face training with internal and external client
- Bachelor's degree preferred with Healthcare/Health Plan or
Medicare/ACA background required
- Minimum of 3 years' experience in a healthcare, health
insurance, enrollment/claims processing; with proficient knowledge
of Risk Adjustment and government audits as demonstrated with
- 3-5 years of experience with training execution and
- High level of professionalism
- Must be self-directed and escalate concerns with potential
- Proficiency in Microsoft Office Suite and proprietary software
- Strong written and verbal communication internally and client
- Excellent organizational skills and priority setting for self,
team, and client(s)
- Ability to present to clients
- Minimal US based travel - not to exceed 10%
- New York State Driver's License
- Independent means of transportation
- Physical ability to travel if necessary
Please forward resumes to Careers@Cognisight.com
Keywords: Rochester General Health System, Rochester , Audit Specialist / Trainer - Cognisight, Other , Rochester, New York
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