Audit Specialist / Trainer - Cognisight

Company: Rochester General Health System
Location: Rochester
Posted on: June 7, 2021

Job Description:

Job Description:

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 multiple clients.
• 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 source systems.
• Create and maintain documentation in support of CMS mandated audit of health insurance plans' demographic and claims information.
• 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 client.
• 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 audience.

Requirements:

• 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 health plans
• 3-5 years of experience with training execution and documentation
• High level of professionalism
• Must be self-directed and escalate concerns with potential solutions
• Proficiency in Microsoft Office Suite and proprietary software tools
• Strong written and verbal communication internally and client facing
• 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%

Additional Requirements:

• New York State Driver's License
• Independent means of transportation
• Physical ability to travel if necessary

Please forward resumes to Careers@Cognisight.com

Thank you.

Keywords: Rochester General Health System, Rochester , Audit Specialist / Trainer - Cognisight, Other , Rochester, New York