• Code Facility Outpatient accounts - Same Day Surgery, Observation, Ancillary, Woundcare Clinic and/or Pain Management records for acute care facilities. • Abstracts clinical data appropriately. • Mitigates diagnosis. • Tolerates short-term assignments for up to two different clients. • Participates in client and Savista meetings and training sessions as instructed by management. • Maintains an ongoing current working knowledge of the coding convention in play at client assignments. • Performs other related duties as required.

At Palm Primary Care (PPC) our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of. With more than 24,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve. Every day, we deliver on our promise to bring value based, quality healthcare to our patients. Overview PPC is looking for a CDI/Certified Professional Coder who will demonstrate deep knowledge in Medical Risk Adjustment, HEDIS, CNS Coding guidelines, billing standards and regulations. A teamwork person who will deliver a high standard of quality of work to drive improved business performance. Duties and Responsibilities - Conduct workflows in Coding and Quality processes, medical record completion and department projects for accuracy in medical record documentation as needed. - Ensures proper code selection for compliance with ICD-10-CM Official Guidelines for Coding and Reporting. - Educates physicians on proper documentation and compliance standards. - Reviews medical record to include consultations (inpatient and outpatient) and hospital discharge summaries to ensure continuity of care and continued coding for accurate risk adjustment. - Performs pre-post audits to ensure medical record completeness, consistency, and compliance. - Works collaboratively with medical and supporting staff to follow-up on documentation needs to support the diagnosis and quality measures based on patient age and chronic conditions. - Uses only pre-approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure. - Develops and maintains professional skills and knowledge through training programs including education sessions for ICD-10-CM and CPT codes. - Demonstrates a thorough understanding of Coding Guidelines. - Demonstrates understanding of company policies which impact Coding functions and takes ownership for compliance for own area of responsibility. - Collaborates with Supervisor as necessary to clarify and verify information. Reports opportunities identified in concurrent and retrospective clinical documentation to support quality, regulatory compliance, and effective coding. - Participates in department meetings. Consistently demonstrates awareness and willingness to fulfill Service Excellence Commitments. - Works collaboratively with team members, other departments, and clinical staff consistent with the Mission and Vision of the company. - Willingly performs similar or related tasks as assigned. - Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary. - Reports any issues to Quality, Compliance and Operations as necessary. - Accurately enters all identified and validated procedures codes in claims into the practice’s EMR. - Assists in all RAPS submission projects as they occur if needed. - Performs all other coding and documentation reviews and/or projects as asked and assists/coordinates strategies as defined by the department head or assistant. Education and Experience: - Certified Professional Coder (CPC) through AAPC or AHIMA. - 2 years of experience as Certified Professional Coder at minimum. - Proficient in assigning ICD-10-CM codes according to provider documentation level to comply with federal regulations and insurance requirements. - Computer skills, Word, Excel, HER. - Ability to travel to medical centers if needed and/or work remotely. - Foreign graduate, nurse, or some Medical background is a plus. Required Skills/Abilities: - Excellent verbal and written communication skills. - Excellent customer service skills. - Excellent organizational skills and attention to detail. - Ability to effectively present information in one-on-one situations to providers, office staff, insurance companies, and other employees. - To perform this job successfully, an individual must have knowledge of Microsoft Word, Excel, Internet software, Email software, and insurance web sites. - Strong sense of business ethics. - Ability to follow company policies and procedures. Physical Requirements: - Prolonged periods of sitting at a desk and working on a computer. - While performing the duties of this job the employee is regularly required to sit, use hands and arms, talk and hear. - Must be able to lift up to 10 pounds at times. Benefits: - Health insurance - Dental Insurance - Vision insurance - Life insurance - 401(k) - Paid time off Schedule: - 8 hour shift - Day shift - Monday to Friday Job Type: In Office Palm Primary Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Primary Care makes hiring decisions based solely on qualifications, merit, and business needs at the time.

Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers Job Description Under the direction of the Director or Manager of Revenue Cycle Management, the Medical Claims Billing Specialist (Accounts Receivable (AR) Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. Primary Job Duties: - Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring. - Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives. - Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques. - Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate. - At times, support large care center go lives which may include overnight travel. - Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements. Performs Denial analysis utilizing the Trizetto platform. - Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality - Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals. - Other duties as assigned. Qualifications - High School Graduate - 3+ years experience in a physician medical billing office - OBGYN billing experience highly preferred - Athena EHR experience highly preferred - CareFirst MD experience preferred - Medicare Advantage & USDOL experience preferred - Experience with major payers such as Anthem, Medicare/Medicaid, United Healthcare, Carefirst also preferred. - Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims & denial trends. - Advanced Microsoft Excel & Google Sheets skills (e.g., pivot tables, VLOOKUP, sort/filtering, formulas) and proficiency in Google Sheets preferred - Must comply with HIPAA rules and regulations The hourly range for this role is $24.45/hr to $26.45/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. - Department: Revenue Cycle

Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers Job Description Under the direction of the Director or Manager of Revenue Cycle Management, the Medical Claims Billing Specialist (Accounts Receivable (AR) Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. Primary Job Duties: - Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring. - Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives. - Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques. - Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate. - At times, support large care center go lives which may include overnight travel. - Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements. Performs Denial analysis utilizing the Trizetto platform. - Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality - Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals. - Other duties as assigned. Qualifications - High School Graduate - 3+ years experience in a physician medical billing office - Athena EHR experience required - OBGYN billing experience preferred - CareFirst MD experience preferred - Medicare Advantage & USDOL experience preferred - Experience with major payers such as Anthem, Medicare/Medicaid, United Healthcare, Carefirst also preferred. - Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims & denial trends. - Advanced Microsoft Excel & Google Sheets skills (e.g., pivot tables, VLOOKUP, sort/filtering, formulas) and proficiency in Google Sheets preferred - Must comply with HIPAA rules and regulations The hourly range for this role is $24.45/hr to $26.45/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law. - Department: Revenue Cycle