Please send all resumes to Caesar Abutin at:
caesara@lhpipa.com
or fax to 562-531-0937
Risk Adjustment Coder
The Risk Adjustment Coder is responsible for handling risk adjustment related activities to ensure that CMS coding and documentation guidelines are met and members risk scores are accurately reflected. This position will assist in developing strategies to improve risk score performance through collaborations with health plans and providers. The responsibilities include performing chart reviews to identify coding opportunities, lead training seminars, physician education, perform internal chart audits to ensure preparedness for potential RADV audits, and other projects as assigned. The position requires 3+ years of healthcare coding experience, understanding of managed care, strong knowledge of CMS risk adjustment guidelines, CPC license or equivalent, strong communication skills with the ability to perform group presentations, strong data analysis, computer proficiency, and valid CA drivers license.
Eligibility and Capitation Coordinator
We are currently seeking for an Eligibility and Capitation Coordinator. Under the direction of the Eligibility and Capitation Manager, the candidate is responsible for answering eligibility and capitation calls, researching eligibility and capitation questions, reconciling eligibility with capitation reports, processing eligibility transactions and filing reports. This person should be flexible and must be able to meet strict deadlines. Minimum of one year healthcare experience is required. Must possess good computer skills. Must have a high school diploma or higher. EZCAP experience, a plus.
