Temporary Professional Integrated Services
San Juan, PR, United States
Job Title Responsible for evaluating CHRA (Comprehensive Health Risk Assessment) forms received from Classicare policyholders and coding the documented clinical information according to the guidelines established by the unit. Essential Functions Performs coding of diagnoses documented in the CHRA (Comprehensive Health Risk Assessment) and registers the data into the appropriate application. Works on post-payment audits of adjudicated claims based on the information contained in the Comprehensive Health Risk Assessment comparing it to the information required, following the operational guidelines established by the unit. Generates referrals through the electronic app used in the Unit with providers and/or billing representatives, related to CHRA document management, to guide them and/or request correction of medical diagnoses due to incorrect coding, and inadequate, ambiguous, or incomplete medical documentation. Processes adjustments received for corrections in the CHRA,...