Do you have the career opportunities you want in your current role? We have an exciting opportunity for you to join the nation’s largest provider of healthcare services as a HCC Risk Management Specialist.
HCA Healthcare is a national leader in providing modern, culturally competent, patient-centered care and we are driven by a single goal: the care and improvement of human life.
We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe in our team and your ability to do excellent work with us. Your benefits include 401k, PTO medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, and employee stock purchase program. We would love to talk to you about this fantastic opportunity.
The HCA Physician Services Group (PSG) is the physician and practice management solution for the Hospital Corporation of America (HCA). We lead a collection of highly motivated healthcare professionals just like you and creative leaders who are committed to excellence in every patient interaction. Are you excited yet?
Pacific Partners Management Services (PPMSI) is a managed services organization formed in 1997 with administrative offices located in Foster City, CA. We provide services to IPAs in the Santa Clara and Monterey Bay areas. Our managed care and ACO services support approximately 1,000 independent physicians and include executive management, full financial services, utilization management, quality improvement, credentialing, contracting, claims processing and provider and member network services.
PPMSI is part of HCA Physician Services Group (PSG), the physician and practice management solution for the Hospital Corporation of America (HCA). PSG operates more than 750 practices, Urgent Care Facilities, and partners with HCA’s 165 hospitals to structure employed provider programs, professional service agreements, and joint ventures that offer the communities we serve high quality, cost effective care. We manage a collection of highly motivated and innovative leaders who are committed to excellence in every aspect of their career.
to learn more
Position requires the candidate to reside in the Bay area, and be driving distance to San Jose, CA.
The HCC & Risk Management Specialist’s primary function is to assist and educate physician providers on proper coding of all current medical conditions to the highest specificity according to Medicare requirements for the Hierarchical Condition Category (HCC) risk adjusted payment model.
What you will do in this role:
Contact and visit physician provider offices regularly to review charts and ensure proper coding of all current medical conditions to the highest specificity according to Medicare requirements for the Hierarchical Condition Category (HCC) risk adjusted payment model.
Educate providers and staff about HCC based guidelines and updates.
Ensure that billing staff understand the importance of correctly adding diagnosis codes to claims.
Conduct training sessions for physicians and/or staff as needed.
Develop and maintain coding reference sheets by specialty.
Update the HCC manual on a yearly basis to reflect any changes.
Review reports and take appropriate actions accordingly.
Communicate with providers and staff in case of any changes, updates and deadlines.
Identify HCC conditions that require patient outreach, chart review or physician education.
Manage retrospective chart reviews with vendors and health plans.
Manage home health assessment programs with vendors.
Work with health plans on achieving project goals.
Other duties as assigned to support the success of HCC risk adjusted payment model program.
Qualifications
What Qualifications you will need:
ICD-10 Certified Professional Coding Certificate.
Minimum 2 years coding and/or billing experience.
Minimum 1 year experience with HCC coding and risk adjustment
Knowledge of ICD-10 codes and taking courses as necessary to maintain certification.
Proficiency in Excel and Word software programs.
Excellent written and verbal communication skills.
Ability to effectively communicate with physicians, and provider office staff.
Ability to research clinical and non-clinical issues.
Ability to maintain confidentiality.
Ability to become technically proficient in Access Express and Ascender as well as reading reports.
Ability to research and multi-task utilizing critical thinking skills.
This position requires driving to Santa Clara County.
HCA Healthcare ranks on Fortune’s list of Most Admired Companies for three consecutive years and HCA ranks 63rd on the Fortune 500 list. In addition, Ethisphere named HCA as one of the World’s Most Ethical Companies. We want you to join our tradition of excellence. Intrigued? We’d love to hear from you.
If you find this opportunity compelling, we encourage you to apply. We promptly review all applications. If you are highly qualified, you will hear from one of our Practice Managers. We are actively interviewing so apply today.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
HCA Healthcare
No comments:
Post a Comment