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Clinical Coding Quality Specialist Job in Henderson, Nevada

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Job Title: Clinical Coding Quality Specialist

Employer:P3 Health Partners
Type:Full-Time
Skills:Risk Adjustment coding; E and M coding; physician education
Required Certifications:CPC
Preferred Certifications:CRC
Required Experience:1 to 2 years
Location:Henderson, NV
Date Posted:9/5/2019
The Clinical Coding Quality Specialist is responsible for working with the P3 Clinical Coding QA Manager to ensure the quality and integrity of codes abstracted or validated by internal coding staff or vendors working with P3 Comprehensive Clinicals department to enable complete and accurate coding compliance with proper medical record documentation. This will include building and managing relationships, processes and audits with vendors that result in accurate and complete submissions to health plans working with P3 Health Partners. S/He will develop and provide training to familiarize new vendors with the company’s business processes, coding policies and systems; track, measure, evaluate and report the status of vendor performance; and ensure the vendors meet or exceed their contractual obligations by delivering quality services as defined by their statements of work (SOW) and service line agreements (SLA’s). Similar metrics and performance standards will be established and maintained for internal P3 clinical coding teams. Current coding certification through AAPC or AHIMA (CPC, CCS, RHIT), CRC is required. Must have experience and understanding of Medicare Risk Adjustment compliance rules, regulations and coding guidelines Ability to coordinate with vendors and their teams, implement and monitor corrective actions. Must be experienced in risk adjustment coding for the CMS Medicare Advantage populations. Responsible to training internal teams and vendors on company and specifically Comprehensive Clinical policies, process and project expectations. Will perform quality assessments on vendor work, including feedback and education when necessary.

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www.p3hp.org

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