WorcesterRecruiter Since 2001
the smart solution for Worcester jobs

Patient Chart Review Specialist - Great CPC Opportunity!

Company: Fallon Community Health Plan
Location: Worcester
Posted on: September 17, 2020

Job Description:

Patient Chart Review Specialist - Great CPC Opportunity!US-MA-WorcesterJob ID: 6065Type: Full Time# of Openings: 1Category: Risk AdjustmentFallon Health - Corp HQOverview About Fallon Health Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. Brief Summary of Purpose: The Chart Review Specialist primary responsibility is to review, analyze and report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details and documentation observations from multiple chart sources to validate diagnostic profiles. The CRS must demonstrate the ability to oversee the chart review life cycle from scheduling access, collecting images, coding chart and updating data software. The CRS must have the ability to code on both and INP and OPD basis. Will participate in monthly Inter-rater reliability discussions to develop and enforce coding P&Ps and define Coding Standards and best practices. Accept assignment from the Manager. Maintain strong interdepartmental relationships. Light travel may be required. Responsibilities

  • Perform retrospective chart reviews for designated populations & volumes
  • Own chart review process from start to end
  • Collect documentation feedback and submit to Manager for provider education efforts
  • Update risk adjustment software with all relevant chart review observations
  • Meet or exceed daily chart review targets
  • Develop and present concise provider-specific feedback for targeted providers and provider groups.
  • Identify diagnoses for submission as well as deletion in support of claims adjustment efforts
  • Ensure chart reviews and related claims adjustment activities completed within regulatory data submission timelines and within CMS Coding and Coding Clinic guidelines
  • Participate in corporate projects and subgroup meetings.Complete analyses related to corporate projects and business needs as needed.
  • Participate in regional Coding Chapter meetings Qualifications Education: High School diploma or GED required. Associated degree preferred . Certification/License:
    • CRC, CPC-C or CPC-P is required
    • Reliable transportation required Experience:
      • HCC coding knowledge preferred 2 years
      • Ability to abstract and code diagnosis information from the medical record.
      • Medical terminology
      • Requires technical expertise in ICD-9-CM or ICD-10-CM
      • Basic MS Office skills; Excel and or Access Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. PM16

Keywords: Fallon Community Health Plan, Worcester , Patient Chart Review Specialist - Great CPC Opportunity!, Other , Worcester, Massachusetts

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Amazon Warehouse Attendant (Seasonal Part-Time) - With $500 Sign-on Bonus - Earn $15/hr or more
Description: Job Description Seasonal Part-time Warehouse Team Member - 500 sign-on bonus Hourly pay rate: Earn 15.25- 18.25/hr , plus benefits and a 500 bonus The base pay for this role is 15.25/hr. We are (more...)
Company: Amazon
Location: Woonsocket
Posted on: 09/29/2020

Amazon Warehouse Attendant (Full-Time) - Day and Night Shifts Available - Up to $1000 sign on Bon...
Description: Job Description Seasonal Full-time Warehouse Team Member - 1000 sign-on bonus Hourly pay rate: Earn 15.25 - 18.25/hr, plus benefits and a 1,000 sign-on bonus. Limited-Time Opportunity Location: (more...)
Company: Amazon
Location: Woonsocket
Posted on: 09/29/2020

Warehouse Team Member - Earn up to $18.25/hr plus benefits and a $1000 sign-on bonus
Description: Job Description Seasonal Full-time Warehouse Team Member - 1000 sign-on bonus Hourly pay rate: Earn 15.25 - 18.25/hr, plus benefits and a 1,000 sign-on bonus. Limited-Time Opportunity Location: (more...)
Company: Amazon
Location: Woonsocket
Posted on: 09/29/2020


Amazon Picker/Packer - Immediate Hire
Description: Job Description Warehouse Team Member Part-Time, Full-Time, Flexible Hours Shifts: Overnight, Sunrise, Day, Evening, Weekend Location Fall River, MA Job opportunities vary by location. We update postings (more...)
Company: Amazon Workforce Staffing
Location: Woonsocket
Posted on: 09/29/2020

Warehouser (Different Shifts Available) - Up to $1000 sign on Bonus + Benefits
Description: Job Description Seasonal Full-time Warehouse Team Member - 1000 sign-on bonus Hourly pay rate: Earn 15.25 - 18.25/hr, plus benefits and a 1,000 sign-on bonus. Limited-Time Opportunity Location: (more...)
Company: Amazon
Location: Woonsocket
Posted on: 09/29/2020

D'Angelo Grilled Sandwiches: Delivery Driver D'Angelo'S
Description: Apply Description Delivery
Company: D'Angelo Grilled Sandwiches
Location: Woonsocket
Posted on: 09/29/2020

Part Time Retail Inventory Associate - Travel Team - Zone 374 - Woonsocket, RI- $400 Sign on Bonus
Description: Job Description 400 Sign on bonus To be eligible, the new employee must work 150 hours in their first 8 weeks of employment, from their start date. Further details will be provided upon hire District (more...)
Company: RGIS
Location: Woonsocket
Posted on: 09/29/2020

Warehouse Attendant (Full-Time) - Earn up to $18.25/hr plus benefits and a $1000 sign-on bonus
Description: Job Description Seasonal Full-time Warehouse Team Member - 1000 sign-on bonus Hourly pay rate: Earn 15.25 - 18.25/hr, plus benefits and a 1,000 sign-on bonus. Limited-Time Opportunity Location: (more...)
Company: Amazon
Location: Woonsocket
Posted on: 09/29/2020

Amazon Warehouse Assistant (Full-Time) - Earn up to $18.25/hr plus benefits and a $1000 sign-on ...
Description: Job Description Seasonal Full-time Warehouse Team Member - 1000 sign-on bonus Hourly pay rate: Earn 15.25 - 18.25/hr, plus benefits and a 1,000 sign-on bonus. Limited-Time Opportunity Location: (more...)
Company: Amazon
Location: Woonsocket
Posted on: 09/29/2020

Amazon Order Picker/Packer
Description: Job Description Warehouse Team Member Part-Time, Full-Time, Flexible Hours Shifts: Overnight, Sunrise, Day, Evening, Weekend Location Fall River, MA Job opportunities vary by location. We update postings (more...)
Company: Amazon Workforce Staffing
Location: Woonsocket
Posted on: 09/29/2020

Log In or Create An Account

Get the latest Massachusetts jobs by following @recnetMA on Twitter!

Worcester RSS job feeds