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Medicare Risk Adjustment Specialist

OUR CULTURE - 5 STAR SERVICE

At Physician Partners, we give you the power to transform lives.  Working together as a team to shape the future of healthcare, we are at the forefront of innovation and best practices to improve the health of our communities. Our team provides the platform, technology solutions and new health programs in a collaborative environment to our primary care providers with the sole purpose of achieving Better Health.  Our commitment, our passion and our culture sets us apart from others and is the cornerstone of everything we do. Our team settles for nothing less than a new and profoundly better way of delivering truly proactive health care rather than simply building a better version of the same old reactive sick care model that serves our communities today.

THE OPPORTUNITY

We are currently searching for a highly engaged, self-motivated, enthusiastic and service-oriented team member who will assist our network of primary care providers in identifying and resolving gaps in clinical documentation.  The ability to work in a fast-paced environment while working with other teams as you continue to provide better health to countless numbers of patients.

THE WORK

This position reports directly to the Quality Department Senior Manager of Operations in our Tampa office located on Harbour Island.  The team member is required to work in the office everyday.

Daily responsibilities include but are not limited to:

  • Identifies training needs; prepares summary reports and conducts coaching as appropriate for MD, DO, PA, NPs and other staff members to improve the quality of the documentation to reflect members’ health data.
  • Identify suspect medical conditions and query the providers to evaluate the patients for all other potential coexisting conditions.
  • Review all clinical indicators and discuss with the providers to appropriately diagnose and document the severity of the illness.
  • Ensure compliance with all federal and state laws related to coding and documentation guidelines
  • Ensure diagnosis codes for each chronic or major medical condition have been captured and supported by documentation guidelines for coding and reporting to CMS
  • Communicates and coordinates concurrent chart reviews with physicians and shares feedback related to review to ensure addendums are done within CMS allowed time frame.

JOB REQUIREMENTS

  • Subject Expertise: Strong medical terminology and good understanding of body systems, anatomy, physiology and concepts of disease processes
  • Communication: Ability to be professional, clear and articulate in both written and verbal form with people within the company as well as with external partners
  • Time Management: Ability to work efficiently under pressure and tight deadlines with minimal supervision
  • Problem Solver: Independently and proactively manage issues and people
  • Interpersonal Skills: Ability to engage people of varying backgrounds
  • Technology: Proficient computer-based skills including Microsoft Office and Google products
  • Time Management: Self-motivated ability to juggle multiple projects with prioritization, superb accuracy, and effective execution
  • Organized and Detail-Oriented: Multitasking and attention to detail is a must
  • Collaboration:  Be an A+ Player on the BEST Team in Healthcare!

KEY ATTRIBUTES

  • Enthusiastic
  • Service Oriented
  • A+ Team Player
  • Perfectionist
  • Enthusiastic
  • Logical / Problem Solver
  • Consistent
  • Service Oriented
  • Diligent
  • Eager
  • Owns It
  • Motivated
  • Determined
  • Professional
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