We are seeking a proactive, highly organized, detail-oriented individual with:

Required:

• A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification
• A Certified Risk Adjustment Coder (CRC)
• Reliable transportation to conduct ongoing face-to-face interactions with providers in the Los Angeles area
• Five or more years of experience with physician billing and/or coding
• Three or more years of recent experience in CMS-HCC Risk Adjustment models V24 and V28
• Three or more years of experience in providing education to clinical and non-clinical staff
• Understanding of RADV and audit processes,
• Detailed knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems 
• Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications
• Knowledge of HIPAA requirements, anatomy and physiology
• Proficient in MS Word, Excel, PowerPoint and Outlook
• Ability to work effectively with common office software, coding software, and EMR systems
• Bachelor’s degree (healthcare or relevant field) or equivalent experience/training

• Six or more years of clinic or IPA and/or managed care experience
• Knowledge of Medicare Advantage billing/claims submission and other related actions
• Ability to work effectively with common office software, coding software, and EMR systems
• Registered Nurse (RN) or clinical qualifications 

Note: Skills may be subject to test.