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

Integrated Resources, Inc

Newark, New Jersey

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JOB DETAILS
JOB TYPE
Contractor
SKILLS
Business Analysis, Capacity and Performance Management, Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Claims Processing, Clinical Research, Content Delivery/Distribution, Data Quality, Department of Health and Human Services, Healthcare, Healthcare Administration, Healthcare Providers, Information Technology & Information Systems, Leadership, Medical Coding, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Network Administration/Management, Network Performance/Analysis, Performance Metrics, Project/Program Management, Rehabilitation Nursing, Risk, Risk Analysis, Risk Management, Status Reports, Support Documentation, Training/Teaching Materials, Trend Analysis
LOCATION
Newark, New Jersey
POSTED
1 day ago
Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS)A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.Job DescriptionOne of our direct client is looking for potential candidate with the below mentioned skillsDirect Client: Immediate InterviewContract to HirePosition: Provider LiaisonMUST HAVE:5 years of experience into Project ManagementAt least 2 years of experience after CPC or CCS certificationBachelor's degree is a mustCertificationsAAPC 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 insightsWorks 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 analysisCollaborates with the Network Management leadership in developing, monitoring and driving key performance metrics for Network Management Provider EducatorsCollaborates 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 staffValidates documentation against submitted claims diagnosis codes and prepares detailed reportsSupports Risk Adjustment Data Validation auditsDrives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work streams are accurately identified and addressedProvides status reports to managementCertifications: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 modelMastery of medical coding best practicesProject management skillsExperience displaying ability to think analyticallyStrong communications and presentation skillsComputer skills: Outlook, Excel, Word & Powerpoint; SAS & Access preferredQualificationsEducation Experience:Bachelor's degree in business, healthcare administration, or other related fieldRequires a minimum of three (3) years of healthcare experience, preferably with provider focusRequires CPC or CCS certificationRequires program/project management experience

About the Company

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Integrated Resources, Inc