What does a risk adjustment analyst do?
Career: Risk Adjustment Analyst
A Risk Adjustment Analyst reviews healthcare data to ensure accurate risk assessments for insurance plans. They analyze medical records, claims data, and coding practices to identify gaps or inaccuracies in risk adjustment reporting. Their work helps healthcare organizations optimize reimbursement and comply with regulatory requirements. Strong analytical skills, knowledge of risk adjustment models, and proficiency in medical coding (ICD-10, HCC) are essential for this role.