HCC Risk Adjustment Trainer

Regal Medical Group • Los Angeles, CA

12d • $90,000 - $100,000

About The Position

The HCC Trainer,Risk Adjustment is responsible for working under the lead
supervision of the Sr. Director and in collaboration with the senior leadership
of Risk Adjustment to maintain, improve and deliver the best risk adjustment
metrics. Coordinates and performs projects/initiatives as delegated by the
executive leadership. The HCC Trainer oversees opportunities of assessing risk
adjustment needs among the assigned network and accounts for operational and
fiscal performance of all providers and partners.

Requirements

• Experience in Managed Care
• Clinical experience preferred
• Coding experience or Master’s a plus
• Ability to work with all levels of management
• Must have excellent verbal and written communication skills
• Proficient in MS Office programs(i.e. Word, Excel, Outlook, Access and Powerpoint)
• Must be a able to travel within service area and have a valid state driver’s license and insurance

Responsibilities

• Audit Provider patient charts and analyze for proper documentation. Also, review all other chart documents to identify potential conditions that Provider may not have listed.
• Subjective – History of chief complaint or current status of symptoms
• Objective – Results of all examinations
• Assessment – Current and chronic conditions written as stated on superbill
• Plan – Explanation of treatment.
• Review audit findings with Provider and provide any substantiating medical background to the findings.
• Ensure that Provider performs proper follow-up to provide care for the patient as indicated in the audit findings.
• Train and mentor Risk Adjustment staff.
• Accountable for increasing organization’s Risk Adjustment metrics in order to place company within the upper quartile of the industry.
• Experience in chronic condition diagnostic coding, clinical lab results and pharmacy interactions.
• Serve as the Risk Adjustment lead in interfacing with all levels of management.
• Conducts regular on-site Risk Adjustment trainings for providers and staff.
• Daily interaction with direct supervisor on operational needs among assigned network.
• Assist in design and implementation of annual Risk Adjustment incentive programs.
• Establish provider relationships and ensure problem resolution.
• Maintain patient confidentiality so that HIPAA compliance is observed at all times.
• Assist with special projects as assigned.
• All other duties as directed by management.

Benefits

• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Vision insurance
• Zero co-payments for employed physician office visits
• Flexible Spending Account (FSA)
• Employer-Paid Life Insurance
• Employee Assistance Program (EAP)
• Behavioral Health Services
• 401k Retirement Savings Plan
• Income Protection Insurance
• Vacation Time
• Company celebrations
• Employee Assistance Program
• Employee Referral Bonus
• Tuition Reimbursement
• License Renewal CEU Cost Reimbursement Program
• Business-casual working environment
• Sick days
• Paid holidays
• Mileage

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed