Provider Coding Educator

4 days ago

Orange, United States Alta Hospitals Full time

The Provider Coding Educator is responsible for supporting and tracking RAF/HCC and coding education for clinical providers. This role will identify and support providers who would benefit from Medicare risk adjustment training.With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.preparing and conducting provider education training, materials, chart reviews, creating feedback reports, etc.Help design an education program that is tailored to the needs of the providers including determining the best method for interacting with providers.Implement education and provide formal training to providers and staff as needed regarding coding compliance, documentation guidelines, HCC education, and Medicare/Medicaid regulations.Educating providers on documentation improvement for compliance and optimum patient quality of care.Provide feedback and present solutions to the Leadership Team of Performance Programs for general and individual provider education. Helps in creating policies and procedures for monitoring reviews, queries, query tracking, education, and interaction with providers.Conforms with accepted standards of conduct in provider education and ethical queries.Educating providers on documentation to accurately reflect the patients overall health status.Develop customized provider-specific plans to improve documentation.Conduct provider chart reviews as needed to aid in provider education.Implement education and provide formal training to providers and staff as needed regarding coding compliance, documentation guidelines, HCC education, and Medicare / Medicaid regulation.Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations.Schedule provider education sessions independently or in collaboration with Network Management.Develop and maintain provider education tracking database.Training providers on RAF methods and tools and working toward compliance.Utilize management for escalation purposes.Maintain strictest confidentiality based on HIPPA policies.Local travel to provider offices in Los Angeles, Orange County, Inland Empire, and San Diego up to 70%Other duties as assigned.Three (3) years of experience in healthcare including provider relationship management, ICD9/10 coding preferred.Experience in a clinical setting is preferred.High school diploma or equivalent required.CPC, CCS, CCS-P, or other recognized coding certification from accredited source (e.g., American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required.*Location-Based Pay Adjustment"

  • HCC Coding Specialist

    1 month ago

    Orange, California, United States Alignment Healthcare Full time

    About Alignment Health:Alignment Health is a pioneering organization in the healthcare sector, dedicated to enhancing the quality of care for seniors. We are currently looking for a Coding Specialist to become a vital part of our innovative team.Position Summary:Oversee and execute HCC coding methodologiesReview all RAPS submissions for precisionOffer coding...

  • Code Enforcement Officer

    3 days ago

    Orange, Texas, United States The City of Port Orange Full time

    Job Title: Code Enforcement OfficerWe are seeking a highly skilled and motivated Code Enforcement Officer to join our team at The City of Port Orange. As a Code Enforcement Officer, you will play a critical role in ensuring compliance with City, State, and Federal codes, and contributing to the overall well-being of our community.Job Summary:The Code...

  • HCC Coding Professional

    1 month ago

    Orange, California, United States Alignment Healthcare Full time

    About the RoleWe are seeking a highly skilled HCC Certified Coder to join our Risk Adjustment team at Alignment Healthcare. As a key member of our team, you will play a critical role in ensuring the accuracy and quality of our coding processes.Key ResponsibilitiesMonitor and audit coding quality to ensure compliance with industry standards and...

  • Healthcare Provider Liaison

    7 days ago

    Orange, California, United States Astiva Health, Inc Full time

    Provider Support CoordinatorAstiva Health, Inc. is seeking a highly skilled Provider Support Coordinator to join our team in Orange, CA. As a key member of our healthcare team, you will be responsible for providing exceptional support to our network providers, ensuring seamless operations and high-quality care delivery.Key Responsibilities:Establish and...

  • Healthcare Provider Liaison

    2 weeks ago

    Orange, California, United States Astiva Health, Inc Full time

    Provider Relations CoordinatorAstiva Health, Inc. is seeking a highly skilled Provider Relations Coordinator to join our team in Orange, CA. As a key member of our healthcare team, you will be responsible for building and maintaining strong relationships with our network providers, ensuring seamless operations and exceptional provider satisfaction.Key...

  • Culinary Experience Provider

    2 weeks ago

    Orange, California, United States CocuSocial Inc Full time

    CocuSocial Inc Job DescriptionCompany OverviewCocuSocial Inc is a leading culinary experience provider in the US, backed by Y Combinator. We empower individual chefs and businesses to host a variety of cooking classes, baking classes, wine tasting workshops, and mixology classes.We are growing fast and currently offering service in 16 major cities in the US,...

  • Hospice and Palliative Care Nurse Practitioner Opportunity

    3 days ago

    Orange, California, United States Provider Solutions & Development Full time

    Provider Solutions & Development is seeking a skilled Hospice and Palliative Medicine Nurse Practitioner to join our team.About the Role:As a Hospice and Palliative Medicine Nurse Practitioner, you will provide high-quality patient care and support to individuals with serious illnesses.You will work collaboratively with healthcare teams to develop and...

  • Educational Facilitator

    1 month ago

    Orange, California, United States Best in Class Education Center Full time

    Position OverviewRole Summary: The Educational Facilitator will play a vital role in enhancing the learning experience of students at Best in Class Education Center.Key Responsibilities:Provide personalized tutoring support to students, ensuring they grasp essential concepts.Evaluate and grade homework, tests, and written assignments with provided answer...

  • Montessori Educator

    2 weeks ago

    Orange, California, United States Nobis Inc Full time

    Job OpportunityWe are seeking a dedicated and experienced Montessori educator to lead a class of students through a successful school year. As a key member of our team at Nobis Inc, you will be responsible for creating and implementing a comprehensive educational curriculum that fosters the development of critical thinking skills in students.Key...

  • Cardiology Nurse Practitioner

    4 weeks ago

    Orange, California, United States Provider Solutions & Development Full time

    Job Title: Cardiology Nurse PractitionerJob Summary: Provider Solutions & Development has an exciting opportunity for a Cardiology Nurse Practitioner to join our team in Orange, California.About the Role:As a Cardiology Nurse Practitioner, you will be responsible for providing high-quality patient care and working closely with our team of healthcare...

  • Cardiology Nurse Practitioner

    3 days ago

    Orange, California, United States Provider Solutions & Development Full time

    Job Title: Cardiology Nurse PractitionerJob Summary: Provider Solutions & Development has an exciting opportunity for a Cardiology Nurse Practitioner to join our team in Orange, California.About the Role:As a Cardiology Nurse Practitioner, you will be responsible for providing high-quality patient care and working closely with our team of healthcare...

  • Para-Educator III

    4 weeks ago

    Orange, California, United States Capistrano Unified School District Full time

    Job SummaryThe Capistrano Unified School District is seeking a Para-Educator III to support students with disabilities in a classroom setting. This is a part-time position that requires a high school diploma or equivalent and six months of experience working with children with disabilities.ResponsibilitiesAssist students with disabilities in a classroom...

  • Toddler Educator

    2 weeks ago

    Orange, California, United States Primrose School of West Orange Full time

    Job OpportunityPrimrose School of West Orange is seeking a dedicated and passionate Toddler Teacher to join our team.Job SummaryWe are looking for a qualified and experienced educator to provide a nurturing and engaging environment for our young students. As a Toddler Teacher, you will be responsible for creating a safe and stimulating atmosphere that...

  • Cardiology Nurse Practitioner

    2 weeks ago

    Orange, California, United States Provider Solutions & Development Full time

    Cardiology Nurse Practitioner Job OpportunityProvider Solutions & Development is seeking a highly skilled Cardiology Nurse Practitioner to join our team in Orange, California.About the Role:Provide high-quality patient care as a Cardiology Nurse Practitioner, working closely with physicians and other healthcare professionals.Conduct thorough assessments,...

  • Montessori Educator

    2 weeks ago

    Orange, California, United States Nobis Inc Full time

    Job OpportunityWe are seeking a dedicated and experienced Montessori educator to lead a class of students through a successful school year. As a key member of our team at Nobis Inc, you will create and implement a comprehensive educational curriculum that fosters a welcoming learning environment and provides students with the tools they need to reach their...

  • Education Specialist

    1 week ago

    Orange, California, United States Tutor Me Education Full time

    Job OpportunityTutor Me Education is seeking a dedicated and passionate individual to join our team as a Tutor. As a Tutor, you will play a vital role in supporting students in achieving academic success.Key Responsibilities:Provide one-on-one or group instruction to students in a dynamic and nurturing environment.Assist students with their daily activities...

  • Education Assistant

    2 weeks ago

    Orange, California, United States Orange Unified School District Full time

    About the EmployerThe Orange Unified School District is a leading educational institution serving approximately 28,000 students in grades kindergarten through 12th. Our district encompasses parts of Anaheim, Garden Grove, Orange, Santa Ana, and Villa Park, providing a diverse and inclusive learning environment.Our Vision and MissionWe strive to inspire our...

  • Education Assistant

    2 weeks ago

    Orange, California, United States HireTalent RPO Full time

    Job SummaryHireTalent RPO is seeking a dedicated and compassionate Special Education Teacher Aide to join our team. As a Special Education Teacher Aide, you will play a vital role in supporting students with specialized learning outcomes in a classroom setting.Key Responsibilities:Assist teachers in implementing instructional programs and providing...

  • Program Director for Distance Education

    4 weeks ago

    West Orange, New Jersey, United States Swedish Institute Inc Full time

    {"title": "Program Director for Distance Education", "content": "Job SummarySwedish Institute Inc is seeking a highly skilled and experienced Program Director for Distance Education to lead our online learning programs. The successful candidate will be responsible for ensuring the efficient day-to-day operations of the program, supporting student learning...

  • Provider Support Coordinator

    7 days ago

    Orange, United States Astiva Health, Inc Full time

    Job Title: Provider Support Coordinator (Bilingual - Korean)Target Compensation Range: $23.00 - $26.00/hour, depending on the level of relevant qualifications and experience.About Us:Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to...