Entry Level Risk Adjustment Coder Jobs in Tucson, AZ

Overall Purpose

The Provider Operations Coordinator (POC) role combines responsibilities of managing operational support initiatives while overseeing special projects, with a focus on supporting HEDIS quality gap closures, Risk Adjustment activities, and provider engagement. This multifaceted position requires daily problem-solving, meticulous tracking, and coordination across departments to meet varying and changing requirements. The POC will oversee assigned affiliate groups, providing operational support to clinics to achieve their goals, which may include engaging with internal and external stakeholders with in-person and telephonic outreach to patients for education and engagement on preventative screenings, medication adherence, and follow-up with primary care providers. This position, depending on experience and education, may directly interact  with patients to complete tasks for quality gap closure.

Roles and Responsibilities 

• Build and maintain effective relationships with assigned Affiliate groups to achieve goals and key initiatives. Serve as a liaison between the Affiliate groups and P3 local, regional, and national departments to provide a seamless point of contact.
• Advises and supports affiliate practices as needed with quality (HEDIS/HOS) gaps and conditional documentation by outreach, chart data mining / audits, claims surveillance, quality events (i.e., diabetic eye screening), educating practice employees, etc. Responsible for reviewing data collected to confirm gaps in care are captured.
• Works with the affiliate practices on prioritizing patient outreach and assists affiliate practices with patient outreach and coordinating scheduling new and establish patients outreaching and scheduling patients for visits by finding appointment dates/times that meet patient needs and availability. 
• Partners with assigned groups and other P3 departments to manage high / rising risk patients by actively ensuring coordination of care across all healthcare services provided to the patient (hospital discharge, hospice, MRA, Care Management, Referrals, Quality, etc.) 
• Assists in CSR/IDT/JOC meeting preparation and participate in meetings as requested. 
• Conducts data entry and maintain appropriate documentation and tracking for quality initiatives.
• Educates patients and affiliates on preventative screenings that are being scheduled/performed and the reason for performing them.
• Depending on education and experience – conduct in home HEDIS gap closure for select measures such as blood pressures, diabetic eye exams, point of care hemoglobin a1c testing, distribution of colorectal screening kits.
• Other duties as assigned. 

 Knowledge, Skills, and Abilities 

• Excellent interpersonal, rapport/trust building, and communication skills with patients, providers, internal and external stakeholders.
• Excellent organizational and time management skills. 
• Strong analytical, critical thinking, and problem-solving skills.
• Ability to present information and obtain buy-in on recommendations.
• Ability to handle a fast-paced environment and prioritize tasks based on importance. 
• Ability to work independently or as part of a team. 
• Dedication to maintaining the confidentiality of all patient records. 
• Knowledge of vital signs and other clinical skills related to direct patient care for quality gap closure.

Education and Experience 

• High school diploma/GED required, associate degree in related field or equivalent experience preferred.
• 2+ years experience in healthcare-related fields required, clinical health care related experience, managed care, or Healthplan experience strongly preferred.
• Experience with Microsoft Word, Excel, Power Point, Outlook and general office equipment such as copier, fax machine, required.
• Experience in Electronic Health Records required.
• Medical Assistant Certification or experience as a Pharmacy Tech, Radiology Tech, Lab Tech or similar strongly preferred. 
• Experience with data mining preferred.
• Medical terminology knowledge required, experience with CPT II codes preferred.
• Current CPR Certification preferred.

Work Conditions  

• Availability to travel within assigned region and work from multiple providers offices up to 90% of work schedule.
• Must have a valid driver’s license, safe driving record, and able to furnish reliable transportation.  

Physical Requirements 

• The work environment consists of exposure to physical conditions typical of a normal office environment. Most of the job is performed while sitting and talking/listening on the phone, although the work may require occasional standing or walking and/or the lifting and carrying of small objects up to 25 pounds.

Pay Range - $22-25/hr depending on experience