... and HCC coding Identify diagnoses and develops proper care plan for chronic disease management Provide patient/family/caretaker education and facilitate patient empowerment and quality of life ...
... and HCC coding Identify diagnoses and develops proper care plan for chronic disease management Provide patient/family/caretaker education and facilitate patient empowerment and quality of life ...
... and HCC coding Identify diagnoses and develops proper care plan for chronic disease management Provide patient/family/caretaker education and facilitate patient empowerment and quality of life ...
... and HCC coding Identify diagnoses and develops proper care plan for chronic disease management Provide patient/family/caretaker education and facilitate patient empowerment and quality of life ...
... and HCC coding Identify diagnoses and develops proper care plan for chronic disease management Provide patient/family/caretaker education and facilitate patient empowerment and quality of life ...
... and HCC coding Identify diagnoses and develops proper care plan for chronic disease management Provide patient/family/caretaker education and facilitate patient empowerment and quality of life ...
Temporary Optum Hcc Coding information
What is the difference between Temporary Optum Hcc Coding vs Medical Coder?
| Aspect | Temporary Optum Hcc Coding | Medical Coder |
|---|---|---|
| Certifications | HCC-specific certifications, coding credentials (e.g., CPC, CCS) | Certified Professional Coder (CPC), CCS, or similar |
| Work Environment | Healthcare insurance, risk adjustment, and clinical data analysis | Hospitals, clinics, physician offices, insurance companies |
| Industry Usage | Used mainly in health plans, Medicare Advantage, and risk adjustment programs | Used across various healthcare settings for medical billing and coding |
Temporary Optum Hcc Coders focus on risk adjustment coding for health plans, requiring specific knowledge of HCC models. Medical Coders have broader roles in medical billing and coding across healthcare providers. Both roles require coding certifications but differ in industry focus and work environment.
What is a Temporary Optum HCC Coder?
A Temporary Optum HCC Coder is a healthcare professional who is hired on a temporary basis to review and assign Hierarchical Condition Category (HCC) codes to medical records for Optum, a health services company. Their main responsibility is to ensure accurate risk adjustment coding, which impacts reimbursement rates and quality reporting. Temporary coders may work remotely or onsite and are expected to have expertise in ICD-10-CM coding guidelines, HCC coding, and compliance standards. They help healthcare organizations meet regulatory requirements and maximize appropriate reimbursement. The temporary nature of the role means assignments may last from a few weeks to several months, depending on project needs.
What are the key skills and qualifications needed to thrive as a Temporary Optum HCC Coder, and why are they important?
To thrive as a Temporary Optum HCC Coder, you need a solid understanding of ICD-10-CM coding guidelines, risk adjustment methodologies, and medical terminology, typically supported by a coding certification such as CPC, CCS, or CRC. Familiarity with electronic health record (EHR) systems and specialized coding software like Optum360 EncoderPro or similar tools is often required. Attention to detail, analytical thinking, and strong organizational skills are vital soft skills for accuracy and efficiency in coding tasks. These competencies ensure precise coding, regulatory compliance, and optimal reimbursement, which are crucial for both patient care quality and organizational success.
What are some common challenges faced by temporary Optum HCC Coders, and how can they be addressed?
Temporary Optum HCC Coders often face challenges such as quickly adapting to new coding systems, meeting productivity benchmarks within tight deadlines, and ensuring compliance with constantly updated CMS guidelines. To address these, it's important to leverage available training resources, actively communicate with team leads for clarification, and utilize support tools provided by Optum. Staying organized and proactive about updates can also help maintain accuracy and efficiency while coding in a temporary role.
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Re-posted 8 days ago
Alignment Healthcare rating
7.3
Based on 17 frontline employees who took The Breakroom Quiz
234th of 300 rated insurance
Job description
Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.
By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.
Position Summary:
The Alignment Jump Start Assessment program is a physician-led and advanced practice clinician-driven program that is intended to care for and support Alignment Healthcare patients with complex and chronic care needs. As a JSA Advanced Practice Clinician, you will work within an interdisciplinary team environment that includes physicians, nurse practitioners, physician assistants, case managers, and other health care team members to ensure proper delivery of clinical and home-based patient care. In this role, you will assess, develop, and coordinate options and services promoting quality care in order to achieve optimal health care outcomes while also ensuring cost-effective care complying with Alignment policy and all state and federal regulations. Our members are typically aged 65 and over and home and virtual visits will be between 45 and 60 minutes depending on whether it is an annual or initial visit.
General Duties/Responsibilities:
(May include but are not limited to)
JSA APC's responsibilities
Conduct initial or annual face-to-face patient visits in home and clinic settings
(Follow CMS guidance to make virtual visits when appropriate)
Health Risk Assessment includes:
o Past medical history
o Review of symptoms
o Physical examination
o Medication review
o Cognitive/depression screenings
o Fall assessment/functional assessment
o Immunizations and preventive health screenings including Colonoscopy, Breast Caner screening, Bone density, and diabetes eye exams
o Advance Care Planning and POLST
Update and reevaluate the year-to-year diagnoses following CMS guidelines and HCC coding
Identify diagnoses and develops proper care plan for chronic disease management
Provide patient/family/caretaker education and facilitate patient empowerment and quality of life
Matching care desired with care given while providing true, informed consent
Collaborate with HEDIS/STARS and other Alignment programs and departments to facilitate optimal program integration and continuity of care
Refer patient to an appropriate programs such as Care Anywhere Program
Refer patient to social worker for appropriate community resources as needed
Provide contact information for patient to receive medical assistance to avoid unnecessary emergency room visit and hospitalization
Comply with all HIPAA regulations and maintains security of protected health information (PHI)
Complete EMR documentation with quality that meets Alignment expectations in a timely manner.
Minimum Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Minimum Experience:
a. Computer literacy/EMR proficiency
b. At least one (1) year prior clinical experience
2. Education/Licensure:
Active California state license as a Nurse Practitioner/Physician Assistant
Active Nurse Practitioner/Physician Assistant Board Certification
Medicare Part D Prescriber
Valid California driver license and current automobile insurance
NP (Nurse Practitioner):
i. Active RN License (Must, upon hire)
ii. Active NP License (Must, upon hire)
iii. Furnishing number (Must, upon hire)
iv. NPI Number (Must, upon start)
v. DEA Number (Must, within 6 months of start)
vi. Board Certification: AANP, ANCC (Must, within 6 months of start)
vii. Valid BLS (Basic Life Support) (Must, upon start)
viii. Valid ACLS (Advanced Cardiovascular Life Support (Preferred)
PA (Physician Assistant):
i. Active PA License (Must, upon start)
ii. NPI Number (Must, upon start)
iii. DEA Number (Must, within 6 months of start)
iv. Board Certification: NCCPA (Must, within 6 months of start)
v. Valid BLS (Basic Life Support) (Must, upon start)
vi. Valid ACLS (Advanced Cardiovascular Life Support (Preferred)
2. Other:
a. Knowledge of current clinical standards of care
b. Ability to work independently
c. Excellent communication skills especially with older adults
d. Good time management skills
e. Experience in care of older adult (geriatric) patients preferred
f. Home care experience preferred
g. Computer literacy/EMR proficiency
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.
What Alignment Healthcare employees say
Pay
Benefits
Hours and flexibility
Workplace
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About Alignment Healthcare
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Orange, CA, US