Job Opportunities
Join the Cognisight Team
If one of the opportunities below piques your interest, please email your cover letter and resume to careers@cognisight.com
Account Manager
We are seeking a highly organized and detail-oriented individual to join our Account Management team. Managing multiple client accounts, the Account Manager’s responsibilities include maintaining a thorough knowledge of our business and offerings, managing and strengthening client relationships, identifying new business opportunities, and coordinating with internal teams to deliver on internal and external client expectations.
- Managing multiple clients—in different time zones—with a focus on developing strong relationships and ensuring customer satisfaction
- Collaborating to develop client work plans
- Coordinate and manage all client activities aligned to work plans
- Monitoring all aspects of client activity to meet contracted Statement of Work and Cognisight work plans on a daily basis
- In depth knowledge and ability to articulate all interdependencies associated with client reports
- Developing content and presenting client webinars
- Routinely managing and reporting on all client status’ with accurate updates, gaps, and gap closing plans
- Staying apprised of the Department of Health and Human Services (HHS) regulations, guidelines, and programs with the ability to update impacted work plans and articulate changes to clients
- Routinely conduct client calls with all levels of leadership
- Working in a fast paced and complex organization with regulated deadlines with a strong focus on providing effective account management support to multiple clients
- Healthcare/Health Plan or Medicare/ACA background strongly preferred
- Must be self-directed and escalate concerns with potential solutions
- Minimum of three years demonstrated experience in Account/Client Management
- High level of professionalism
- Bachelor’s degree required
- Working knowledge of risk adjustment and government audits as demonstrated with health plans preferred
- 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)
- Minimal client travel required
Clinical Review Specialist
The Clinical Review Specialist will be responsible reviewing medical records to abstract ICD-10 codes that map to HCCs from a variety of different CMS Hierarchy models including Medicare Advantage, PACE, Commercial, and Medicaid CDPS model. In addition to abstracting diagnosis codes, the Clinical Review Specialist also audits medical records and validates entries that have been submitted to CMS.
- Conducts onsite and remote audits of medical records (paper, EMR, hybrid)
- Adheres to compliance of Medicare, Medicaid, and Commercial risk adjustment guidelines with precision.
- Understands, respects, and applies client specific guidelines
- Adheres to audit and medical record review schedules to meet client expectations and government-regulated deadlines
- Shares trends (positive and constructive) with Coding Manager and Team Leads for client consultation/collaboration
- Regularly participates in peer review; provide and receive feedback
- Ensures accurate documentation to support all audits
- Assures adherence to and currency with internal and external regulatory guidelines:
- CMS/HHS
- DOH
- HIPAA, HITECH, and Fraud Waste & Abuse
- Medical coding protocols
- Provides clinical intellect and expertise to system analytics via project assignments as well as on an ad hoc basis
- Participates on client and prospect conference calls, presentations, and in-person meetings as needed
- Mentors remote contracted staff
- Demonstrates agility to meet client needs
- Maintain coding credentials as required by credentialing agency
- Maintain professional competence as evidenced through attendance in continuing education programs and the like; hours per year dependent on credential(s) held
- Coding credential required (RHIT, RHIA, CCS, CPC, optional additional CRC)
- Minimum of one year HCC coding experience required
- Working knowledge of medical necessity
- Knowledge of Medicare Advantage, Commercial, Medicaid, and PACE risk adjustment methodologies preferred but not required
- High level of concentration and precision
- Ability to use a variety of software tools and reporting
- Must be able to work independently
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