|Employer:||Physician Health Partners
|Skills:||CPC,EMR,Medical Office,Claims Compliance,Medicare,Coding,Auditing,Education,Presenting
|Location:|| Denver 80202, CO, US
Summary: Responsible for educating
and advising providers and practice staff in Medicare coding guidelines,
focusing on revenue enhancement opportunities. Work in collaboration with other
PHP departments and Optum/United HealthCare Medicare Advantage(MA) or other health
plans to develop plans and materials that support education and system changes
to meet practice and IPA revenue goals.
- Associates or Bachelors’ degree required.
- Certified Professional Coder (CPC) Required.
- Minimum two years’ experience in a medical office and/or working with medical records, preferably electronic medical records.
- CRC, CPMA or additional certification preferred.
- Knowledge of health care insurance claims practice and compliance.
- Knowledge of Medicare rules and guidelines.
- Knowledge of Claims Coding (CPT, HCPCs, Revenue Codes, ICD-9/ICD-10, UB92, HCFA 1500).
- Knowledge of risk adjustment categories and hierarchy preferred.
- Knowledge of MS Office Suite, Electronic Medical Records, Encoder, Coding Clinic, other software programs and internet based applications as needed to fulfill position duties.
- Skilled in synthesizing data and questions to communicate a cohesive educational training program.
- Skilled in responding to practice inquiries in a timely and accurate manner.
- Skilled in working collaboratively with various parties to communicate an accurate and meaningful reporting package for practices.
- Able to work effectively with physicians, practice staff, health plan/other external parties and PHP multipdisciplinary team to streamline efforts to meet HCC Coding goals.
- Able to work with sensitive data and relay potential issues or concerns in a diplomatic manner.
- Able to multi-task and meet deadlines.
- Able to work with external parties to obtain resources as needed.
- Able to communicate findings in a clear, concise manner, both internally and externally, including presentations.
- Required Licensure or Certification for this position must be maintained by the employee as defined by the company policies and procedures.
- A valid unrestricted Colorado drivers’ license.
- Reliable and insured vehicle.
- Mobile Device for work purposes as defined by the company policies and procedures.