PROVIDER LIAISON - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS)

One of our direct client is looking for potential candidate with the below mentioned skills

 Direct Client: Immediate Interview

   Contract to Hire

   Position: Provider Liaison

 MUST HAVE: 

• • 5 years of experience into Project Management
• • At least 2 years of experience after CPC or CCS certification     
• • Bachelor’s degree is a must         

  Certifications

· AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)

 Job Summary:

• The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for Network Management professionals to communicate with providers and staff regarding Client's risk adjustment programs. Primary responsibilities include working with the Risk Adjustment Management Business Analyst to measure commercial risk adjustment performance for the development of education materials. Ongoing responsibilities include communicating and educating Network Management Provider Educators to enable content delivery to specific providers. This role will operate within the Risk Adjustment Management function, but work closely with the Network Management team.

Responsibilities:

• Operates as the intermediary between the Risk Adjustment Management team and provider-facing staff to report and deliver commercial risk adjustment insights

• Works closely with the Risk Adjustment Management Business Analyst to monitor risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis

• Collaborates with the Network Management leadership in developing, monitoring and driving key performance metrics for Network Management Provider Educators

• Collaborates with the Network Management leadership in developing and delivering commercial risk adjustment educational content and materials for internal and external use, including clinicians and supporting staff

• Validates documentation against submitted claims diagnosis codes and prepares detailed reports

Supports Risk Adjustment Data Validation audits

• Drives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work streams are accurately identified and addressed

Provides status reports to management

Certifications:

• 

AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)

Knowledge:

• Understands key tenets of commercial risk adjustment and the HHS-HCC risk adjustment model

• Mastery of medical coding best practices

• Project management skills

• Experience displaying ability to think analytically

• Strong communications and presentation skills

• Computer skills: Outlook, Excel, Word & Powerpoint; SAS & Access preferred

Kind Regards

Sammeer Gaikwad

Operations Manager

Integrated Resources, Inc. 

IT Life Sciences Allied Healthcare CRO

Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I

(BOARD) # 732-549-2030 – Ext - 243