Risk Pool Review Specialist

7 days ago


Los Angeles, California, United States MedPOINT Management Full time
Job Overview

MedPOINT Management is seeking an experienced Risk Pool Review Specialist to join our team. As a key member of our Auditing & Recoveries unit, you will be responsible for reviewing and analyzing Risk Pool Summaries to ensure the accuracy and integrity of hospital claims paid by MPM.

**Key Responsibilities**

  1. Review Risk Pool Summaries to identify areas for improvement.
  2. Audit Risk Pool Detail and submit disputes to health plans or Cap Hospital.
  3. Ensure that disputes agreed to are credited back to the pool and pool settlements are paid timely.

**Minimum Requirements**

To be considered for this role, you will need:

  • A high school diploma or equivalent.
  • At least 2 years' experience with hospital claims processing and/or billing.
  • AAPC Coding certification is highly preferred.

**Compensation and Benefits**

The estimated annual salary for this role is $68,000 - $85,000, depending on experience. We also offer a comprehensive benefits package, including medical, dental, and vision insurance, as well as a 401(k) plan and paid time off.



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