People. Passion. Purpose.
At P3 HealthPartners, our promise is to guide our communities to
better health, unburden clinicians, align incentives and engage
patients. We are a physician-led organization relentless in our
mission to overcome all obstacles by positively disrupting the
business of health care, transforming it from sickness care into
We are looking for a Clinical Coding Quality
Specialist. If you are passionate about your work; eager
to have fun; and motivated to be part of a fast-growing
organization in Las Vegas, Nevada, then you should consider joining
Overall Purpose: The Clinical Coding Quality
Specialist is responsible for working with the P3 Clinical Coding
QA Manager to ensure the quality and integrity of codes abstracted
or validated by internal coding staff or vendors working with P3
Comprehensive Clinicals department to enable complete and accurate
coding compliance with proper medical record documentation. This
will include building and managing relationships, processes and
audits with vendors that result in accurate and complete
submissions to health plans working with P3 Health Partners.
Develop and provide training to familiarize new vendors with the
companys business processes, coding policies and systems
Track, measure, evaluate and report the status of vendor
Ensure the vendors meet or exceed their contractual obligations
by delivering quality services as defined by their statements of
work (SOW) and service line agreements (SLAs)
Similar metrics and performance standards will be established
and maintained for internal P3 clinical coding teams.
Education and Experience:
High school diploma or equivalent required.
BS in Business or related field or combination of experience and
Previous vendor contract management a plus.
Current coding certification through AAPC or AHIMA (CPC, CCS,
RHIT), CRC required.
Experience and understanding of Medicare Risk Adjustment
compliance rules and regulations and coding guidelines.
Experience with coordination and oversight of remote vendor
Able to coordinate with vendors and their teams at various
levels to ensure accurate, smooth and timely communication of data
Able to meet deadlines, complete projects within scope and
budget, with successful outcomes.
Strong written and verbal communication skills to summarize
project status and potential corrective actions.
Ability to implement and monitor corrective actions to
continuously improve coding integrity and outcomes for assigned
Advanced Proficiency with MS Word, Excel and Power Point Ability
to manage multiple projects.
Ability to travel.
Knowledge, Skills and Abilities:
Experienced in risk adjustment coding for the CMS Medicare
Understanding of clinical decision making and appropriate
documentation for code validation.
Organized, with focused attention to detail, process and metric
Technology savvy, with advanced Excel and presentation
Creative and energetic individual able to build and sustain
great working relationships within teams and with vendors
partnering with our organization.
Willingness to be cross-trained into related functions, such as
quality and medical management, within a matrixed, integrated work
environment for population health management.
Ability to work independently and collaboratively in a
fast-paced team environment.
Excellent verbal, written and interpersonal communication
Understand and summarize salient points of contracts for
implementation and project timelines with key milestones.
Breakdown system, people and oversight resources needed for each
Develop and deliver training to internal teams and vendors on
company and specifically.
Comprehensive Clinical policies, process and project
expectations, as related to the project Compliant management and
oversight of the delivery of and/or return of protected patient
health information (PHI) between vendor and client health
Nurture ongoing relationships with vendors and work to resolve
issues, and use good judgement for escalation processes.
Identify and implement efficiencies and/or problem resolution
associated with vendor processes without compromising the high
quality and integrity of project outcomes while working within the
scope and budget of the project or contract.
Perform quality assessments on vendor work, including feedback
and education when necessary.
Support programming for multiple markets and business
Cross-training in other departments as needed for high quality
patient care and positive impact on population health.
EQUAL OPPORTUNITY EMPLOYER
We're an equal opportunity employer. All applicants will be
considered for employment without attention to race, color,
religion, sex, sexual orientation, gender identity, national
origin, veteran or disability status.
DIVERSITY & INCLUSION
At P3, we recognize and appreciate the importance of creating an
environment in which all team members feel valued, included, and
empowered to do their best work and bring great ideas to the
Every P3 family member's unique experiences, perspectives, and
viewpoints are valued and support our ability to deliver the best
possible experience for our patients, providers, payers, partners,
and each other.
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