Cano Health

Specialist, Care Quality


PayCompetitive
LocationMiami/Florida
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: JR3061

      It's rewarding to be on a team of people that truly believe in making an impact!

      We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.

      Job Summary

      In this position, you will be responsible for analyzing medical records to allow for accurate coding of diagnoses, visits, and procedures using ICD-10 and CPT classification systems; provide continual feedback to physicians and staff regarding medical record documentation and how it relates to the level of service provided and charged for; provide ongoing coding education to physicians and staff; participate in continuing education courses and seminars to maintain coding knowledge.

      Essential Duties & Responsibilities

      • Audit all records received for validity and correlation with the billing data.
      • Maintain Risk Adjustment database and establish effective strategies for data substantiation and revenue validation.
      • Provide timely and detailed status of updates/changes to make sure all documentation is submitted for correct and accurate payment.
      • Provide feedback to coding staff on audit results.
      • Prepare consultant’s data to be used in report preparation to capture opportunities.
      • Maintain Risk Adjustment database and establish effective strategies for data substantiation and revenue validation.
      • Provide timely and detailed status of updates/changes to make sure all documentation is submitted for correct and accurate payment.
      • Provide feedback to coding staff on audit results
      • Prepare consultant’s data to be used in report preparation to capture opportunities.

      Additional Duties & Responsibilities

      • Ability to multi-task efficiently and effective
      • Communicate effectively by phone, in person and in writing.
      • Adherence to all policies and procedures, including but not limited to standards for safety, attendance, punctuality and personal appearance
      • Participation on medical reviews, EMR updates and any additional training in regards medical documentation

      Supervisory Responsibilities

      • No supervisory responsibilities.

      Education & Experience

      • Medical knowledge, preferred MD
      • Certified Risk Adjustment Coder (CRC) Certification

      Education Requirements

      Education Level

      Discipline

      Required

      High School

      Knowledge, Skills & Proficiencies

      • Comprehensive knowledge of CPT, ICD-10 and the use of modifier.
      • Computer proficiency and ability to quickly learn new applications.
      • Organizational skills with focus on tracking patient care and improving patient flow
      • Fluency in English and Spanish is required to communicate effectively with our patients.

      Physical Requirements

      This position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

      Work Conditions

      Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing

      Travel Requirements

      Amount of Expected Travel

      Details

      Yes

      0-25%

      Work will involve some driving/traveling to assigned clinics.

      Tools & Equipment Used

      Computer and peripherals, standard and customized software applications and tools, and usual office equipment.

      Disclaimer

      The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

      Join our team that is making a difference!

      Please see Cano Health’s Notice of E-Verify Participation and the Right to Work post here

  • About the company

      To improve patient health by delivering superior primary care medical service, while forging a life-long bond with our members.

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