Risk Adjustment Cover Letter

I am excited to be applying for the position of risk adjustment. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for oversight of the entire scope of work related to risk adjustment to ensure efficiency, compliance and effectiveness.

Please consider my experience and qualifications for this position:

• Assure success of project by performing data analysis using SQL
• Produces reports on schedule
• Modifies reports in response to error identification
• Modifies reports in response to change management log approved change requests
• Saves old and new report design for audit trail purposes
• Comprehensive knowledge of Microsoft Word, Excel or Access
• Project Management Certification such as LEAN or working with Agile method
• Healthcare Risk Adjustment experience

I submit this application to express my sincere interest in the risk adjustment position.

In my previous role, I was responsible for leading advice on risk mitigating actions related to clinical services including deals between Philips and Clinical Operators;.

My experience is an excellent fit for the list of requirements in this job:

• Knowledge of Facets, PIMS, and claims processes is preferred
• Knowledge of Medicare, ICD-10, CPT, HCPCS coding standards and guidelines, and Uniform Billing practices
• Has good listening skills
• Demonstrates a bias for action and strong leadership and organizational skills
• Has complete and thorough understanding of Risk Adjustment programs and can translate information at multiple audience levels
• Expertise in reviewing and assigning accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office or facility setting
• A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CRC to understand the impact of diagnosis coding on risk adjustment payment models
• Understand the audit process for risk adjustment models

In response to your job posting for risk adjustment, I am including this letter and my resume for your review.

In the previous role, I was responsible for analytical support in the optimization of risk adjustment related activities while maintaining compliance with CMS standards.

Please consider my qualifications and experience:

• Experience and knowledge of CMS-HCC and CDPS risk adjustment
• Critical thinking, analytic skills
• Professional demeanor and appearance, strong work ethic, reliable, resourceful, enthusiastic team player, positive attitude
• Cumulative 3.0 or better GPA
• Collaboration/relationship building and detail-oriented skills
• Statistical/Analytical design experience
• Knowledge of STARS model and operations
• Strong SQL with SAS, Python, or "R"

I would like to submit my application for the risk adjustment opening. Please accept this letter and the attached resume.

In the previous role, I was responsible for thought leadership and strategic support on risk adjustment and revenue management for both staff and senior leaders.

Please consider my experience and qualifications for this position:

• Demonstrated knowledge of and use of continuous improvement methodologies, tools and techniques (data collection, process mapping, and data analysis)
• Provide direction and give guidance on coding best practices
• Educate healthcare provider, coder and/or office staff about the risk adjustment model, documentation and coding
• Create a long-term, self-sustaining solution for the healthcare provider’s practice
• Assist healthcare providers to document accurately and code to the highest level of specificity in order to capture a member’s true health status at the time of care
• Query providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding
• Perform chart review and identify previously accepted/undocumented conditions to accurately report patient’s true health status
• Assist in chart review for the purpose of reporting CMS STAR quality measures

I submit this application to express my sincere interest in the risk adjustment position.

In my previous role, I was responsible for support and assist in developing strategies, tracking program results and progress, developing procedures and policies for risk adjustment efforts.

Please consider my experience and qualifications for this position:

• Knowledge of anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses
• Demonstrated experience in managing complex projects with both internal and external integration points
• Word, Power Point, and Excel PC skills
• Strong knowledge of ACA and Medicare Advantage markets
• Bachelor’s in Business Administration, Health Care Administration or related field
• Strong financial analytical background with ACA and Medicare Advantage plans
• Advanced PC skills (Excel, PowerPoint, Word, Visio, Outlook, SharePoint, Business Maps, Microsoft Project)
• Possession of strong analytical / statistical skills used in evaluation and analyzing data