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Job Description Summary The Practice Performance Manager (PPM) is responsible for all value-based care initiatives, interventions to support the implementation and transition to Value Based Care processes. The PPM is responsible for providing on-site and remote assistance and /or education to clinicians, care teams and their associated practices to drive improvement in clinical quality, risk adjustment and operational efficiency. The PPM is responsible for partnering with practices to ensure VBC goals are met. This position coaches practice staff to improve patient outcomes by developing skills in process improvement, value-based and team‐based care, encouraging patient engagement, and analyzing quality data and measurements. The PPM is committed to leveraging data and analytics for quality improvement, research, and practice transformation. The PPM will provide guidance and expertise in the development, implementation, and optimization of training materials used to facilitate practice transformation. The PPM will work as part of an interdisciplinary team to create and deliver products and services including user education and training materials, project plans, tool kits, and evaluation materials. Key Responsibilities * Establish a planned care model with practices in integrating administrative, financial, and clinical systems for better performance and improved outcomes. * Develop and implement workflow design and redesign, including electronic health record (EHR) optimization, clinical documentation, billing practices, assessments, financial analyses, and financial performance improvement and reporting. * Works with practice sites on clinical documentation improvement activities, to include chart review, feedback and education. * Utilize available tools to assist clinicians with capturing and analyzing population‐based data to support practices with data‐driven decision making and direct improvement efforts to support practice leadership develop the skills to interpret and act on quality metric data with performance management tactics. * Build trusting relationships to help drive continuous change with physicians/physician staff to find ways to encourage member clinical participation in wellness and education by providing resources and educational opportunities to provider and staff. * Engage directly with patients as needed to schedule annual wellness visits, facilitate referrals, and help with patient navigation. * Develop and implement changes to root causes of financial and quality under performance and communicate strategies to providers and provider groups. * Understand the role of analytics and the importance of clear, defined, and accurate data for improving healthcare outcomes. * Execute responsibilities in a manner that promotes collegial, collaborative, and effective communication to successfully reach mutually agreed upon goals with practice sites and colleagues. * Provide support for other interdisciplinary teams (e.g. s clinical implementation, analysis, research, support services, training, medical record retrieval projects). Qualifications * Bachelors Degree in related field or five years related experience * A license in one of the following is preferred: * Certified Risk Adjustment Coder (CRC) * Certified Professional Coder (CPC) * Certified Professional in Healthcare Quality (CPHQ) * Licensed Vocational Nurse (LVN) * Minimum three years of experience with a focus on EMR operations, use, design, and implementation * Minimum three years of medical practice management, clinical program development, clinical transformation, healthcare quality analytics and/or quality improvement

Job DescriptionDescriptionWe are seeking an experienced and motivated Risk Adjustment Coding Supervisor to oversee and support a team of Risk Adjustment Coders. This role is responsible for supervising daily coding activities, ensuring accuracy and compliance with CMS Risk Adjustment guidelines, and supporting the Manager with day-to-day operations of the Risk Adjustment department. The Supervisor will serve as a subject matter expert in HCC coding, provide guidance and mentorship to coding staff, assist with auditing and quality initiatives, and help drive departmental performance to ensure accurate CMS payment and improved quality of care. The ideal candidate will also be highly data-driven, with the ability to analyze coding, audit, and performance data to identify trends, gaps, and opportunities. This role will leverage data insights to support Risk Adjustment initiatives, improve coder performance, and help design and implement new or enhanced workflows that drive efficiency, accuracy, and optimal HCC capture. *This role requires travel - please refer to job description below. Our Values: • Put Patients First, • Empower Entrepreneurial Provider and Care Teams, • Operate with Integrity & Excellence, • Be Innovative, • Supervise, coach, and mentor Risk Adjustment Coding Specialists to ensure high-quality, compliant coding practices, • Serve as a resource for coders regarding ICD-10-CM, HCCs, CMS Risk Adjustment guidelines, and documentation standards, • Monitor individual and team productivity, accuracy, and quality metrics; provide ongoing feedback and corrective action as needed, • Utilize productivity, quality, and audit data to identify performance trends, coding gaps, and training opportunities, • Translate data insights into actionable feedback, performance improvement plans, and targeted education, • Assist with onboarding and training of new coding staffOperational Support, • Support the Risk Adjustment Manager with day-to-day departmental operations, including workflow coordination, prioritization of audits, and issue resolution, • Assist in developing and maintaining standard operating procedures, workflows, and best practices, • Analyze Risk Adjustment data (e.g., recapture rates, audit findings, productivity, denial trends) to support departmental strategy and prioritization, • Collaborate with leadership to design and implement new or enhanced workflows for coders based on data, performance metrics, and operational needs, • Support reporting and dashboard development to track coding performance, quality outcomes, and Risk Adjustment impact, • Escalate operational, compliance, or performance issues to leadership as appropriateCoding, Auditing & Compliance, • Review provider documentation and medical records to ensure all Medicare Advantage and Commercial Risk Adjustment requirements are met, • Perform and/or oversee retrospective and prospective medical record reviews to identify, assess, monitor, and document HCC coding opportunities, • Conduct coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation, • Analyze audit results to identify systemic coding or documentation trends and recommend process improvements, • Prepare audit analyses and provide feedback on noncompliance or documentation improvement opportunitiesProvider & Staff Education, • Interact with physicians and provider office staff regarding coding, billing, and documentation policies and procedures, • Deliver education and training on Risk Adjustment and documentation improvement, both individually and in group settings, • Certifications, • Certified Coding Specialist (CCS or CCS-P) OR Certified Professional Coder (CPC), • Certified Risk Adjustment Coder (CRC) (not required but highly preferred), • Experience, • Minimum of 4–5 years of medical coding experience, including Risk Adjustment and HCC coding, • Prior lead, senior, or supervisory experience, • Skills & Abilities, • Strong knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC), • Strong data analysis skills with the ability to interpret coding, audit, and performance metrics, • Ability to identify patterns and trends within Risk Adjustment data to inform decision-making and workflow design, • Experience using data to drive operational improvements and support Risk Adjustment initiatives, • Advanced Excel skills preferred (e.g., pivot tables, reporting, data analysis), • Excellent verbal, written, and presentation skills, • Demonstrated ability to educate and train coding staff and provider office personnel, • Expert-level proficiency in Microsoft Word, Excel, Outlook, and PowerPoint, • Strong organizational, analytical, and problem-solving skills, • Other Requirements, • Reliable transportation and valid driver’s license, • Ability to travel up to 75% of the time within the Houston Metropolitan Area.You're great for the role if:, • Have deep expertise in Risk Adjustment and HCC coding, • Are data-driven and comfortable using metrics to guide decisions and improve outcomes, • Enjoy analyzing trends and patterns to enhance Risk Adjustment performance, • Have experience building or refining workflows that improve coder efficiency and accuracy, • Enjoy leading, mentoring, and developing coding professionals, • Thrive in a fast-paced, collaborative environment, • Are detail-oriented and committed to coding accuracy and compliance, • Our organization follows a hybrid work structure where the expectation is to work both onsite and at home on a weekly basis. Up to 75% travel is required in designated market(s)., • The home office of this department is located at 19500 HWY 249, Suite 570 Houston, TX 77070.

Job Description Medical Coding and Billing Instructor/Externship Coordinator Not a remote position Full Time/ Swing 8 am to 4 pm 5 pm to 10 pm Job Description: Have you ever wanted to make an impact on the future generation of Medical Coding and Billing professionals? Do you have a passion for helping people reach their full potential? Do you love working closely with people? If your answer is yes, this career may be just perfect for you. You responsibilities will include delivering curriculum content to our Medical Coding and Billing students. This includes mentoring and helping the students to become professionals. Qualifications: • 3+years of Medical Coding and Billing, • No Teaching experience required.

Job Description Medical Coding and Billing Instructor/Externship Coordinator Not a remote position Full Time/ Swing 8 am to 4 pm 5 pm to 10 pm Job Description: Have you ever wanted to make an impact on the future generation of Medical Coding and Billing professionals? Do you have a passion for helping people reach their full potential? Do you love working closely with people? If your answer is yes, this career may be just perfect for you. You responsibilities will include delivering curriculum content to our Medical Coding and Billing students. This includes mentoring and helping the students to become professionals. Qualifications: • Required CBCS Certified Billing and Coding Specialist, CPC certified Professional coder, or CCS ( certified Coding Specialist) Experience: • 3+years of Medical Coding and Billing LkInpyEK0W

Job DescriptionDescriptionWe are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. *Requires travel to provider sites in surrounding areas *May be open to considering Level I Specialists based on experience and skills Our Values: • Put Patients First, • Empower Entrepreneurial Provider and Care Teams, • Operate with Integrity & Excellence, • Be Innovative, • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company, • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC), • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines, • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation, • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing, • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements., • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives., • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work., • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager., • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC., • 3-5+ years of experience in risk adjustment coding and/or billing experience required, • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time, if applicable., • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook, • Excellent presentation, verbal and written communication skills, and ability to collaborate, • Must possess the ability to educate and train provider office staff members, • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.You're great for this role if:, • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC, • Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience, • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage, • Strong PowerPoint and public speaking experience, • Ability to work independently and collaborate in a team setting, • Experience with Monday.com, • The national target pay range for this role is $75,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors., • This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in the surrounding areas in Beaumont. The home office is located at 19500 TX-249, Suite 570, Houston, TX 77070.

R-404321 Description The Physician serves as a health-care professional and capable of handling a variety of health-related problems. The Physician work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Responsibilities Humana’s Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 175 centers across eight states under two brands: CenterWell & Conviva. Operating as a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a team-based care model where our physicians lead a multi-disciplinary care team supporting patient’s physical, emotional, and social wellness. At CenterWell Senior Primary Care we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all. The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value-based care provider focused on quality of care for the patients we serve. Our care team consists of Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. This robust support allows our PCP to see fewer patients and spend more time with those they do. Responsibilities • Evaluates and treats center patients in accordance with standards of care., • Follows level of medical care and quality for patients and monitors care using available data and chart reviews., • Assists in the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care., • Acts as an active participant and key source of medical expertise with the care team through daily huddles., • Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by displaying a professional and approachable demeanor., • Completes all medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity., • Follows policy and protocol defined by Clinical Leadership., • Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues., • Participates in potential growth opportunities for new or existing services within the Center., • Participates in the local primary care “on-call” program of CenterWell as needed., • Assures personal compliance with licensing, certification, and accrediting bodies., • Current and unrestricted medical license or willing to obtain a medical license in state of practice; eligible and willing to obtain licenses in other states in the region of assignment, as required., • Graduate of accredited MD or DO program of accredited university., • Excellent verbal and written communication skills, • Bilingual English & Vietnamese Required., • Demonstrate a high level of skill with interpersonal relationships and communications with colleagues/patients., • Fully engaged in the concept of “Integrated team-based care” model, • Willingness and ability to learn/adapt to practice in a value-based care setting., • Superior patient/customer service, • Basic computer skills, including email and EMR., • Board Certification or Eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine preferred., • Active and unrestricted DEA license, • Medicare Provider Number, • Medicaid Provider Number, • Minimum of two to five years directly applicable experience preferred., • Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value-based relationship environment., • Knowledge of Medicare guidelines and coverage, • Guaranteed base salary + quarterly bonus., • Excellent benefit package – health insurance effective on your first day of employment, • CME Allowance/Time, • Occurrence Based Malpractice Insurance, • Relocation, • 401(k) with Employer Match, • Life Insurance/Disability, • Paid Time Off/Holidays For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve. If Progressed to Offer, You Will Be Required To • Provide proof of full vaccination or commit to testing protocols OR #physiciancareers Scheduled Weekly Hours 40

Certificate: Certified Professional Coder CPC. Responsible for reading patient charts to determine medical history, including diagnoses and treatment given. Using a set of established medical codes transcribe patient history used by both health care providers and insurance companies.

Job Description Summary Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities * Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application * Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission * Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system * Selects and accurately records all appropriate records and data on assigned chart abstraction projects * Ability to meet productivity and accuracy requirements * Performs other duties as assigned Qualifications * High School Diploma or GED required * A certification in one of the following is required: * Certified Professional Coder (CPC) * Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) years HCC experience performing concurrent and retrospective risk adjustment chart reviews required * Current AAPC or AHIMA credential required * Risk Adjustment / HCC knowledge required * Managed Care experience preferred

LHH is excited to partner with a prestigious global Corporate Services company in search of a passionate and driven Billing Specialist who is ready to make a significant impact in Houston, TX! This company offers a HYBRID work schedule after training.Qualified candidates should have at least one yea

System Coordinator, Patient Accounts II.The System Coordinator, Patient Accounts II serves as the secondary gatekeeper for the Nexus Health Systems Business Office.This position is responsible for handling Central Business Office incoming telephone calls, correspondence, and patient account document

USAI) is an ISO 9001:2015 certified, American manufacturer. USAI differentiates itself as a leading designer, manufacturer, and supplier through the innovation, responsiveness, and professionalism of its employees.

Certified Professional Coder (CPC). Accepted certifications from American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) include:. Certified Coding Associate (CCA) * Certified Coding Specialist (CCS).

LHH is excited to partner with a prestigious global Corporate Services company in search of a passionate and driven Billing Specialist who is ready to make a significant impact in Houston, TX! This company offers a HYBRID work schedule after training.Qualified candidates should have at least one yea

This essential role interacts closely with firm lawyers, other legal and business staff professionals, and firm clients.

We are always looking for bright, motivated, and energetic professionals to add to our world-class team. Unlimited professional training opportunities.

The Billing Specialist is responsible for the final steps of the invoice process, reviewing quoted pricing, applying vendor cost, entering customer invoices in portals, mailing/emailing invoices, and processing credit and rebills.Interpret quotations and contract pricing, shipping papers.Process inv

The organization is committed to employee well-being through flexible remote work arrangements, professional development support, and an inclusive, respectful workplace culture. Scion Staffing is a national award-winning staffing firm! Since 2006, we have had the pleasure of successfully placing tho

Our clients can look forward to having a top notch medical or allied staff that demonstrate a high level of professionalism, punctuality, and reliability.

About the job Billing Specialist.The Billing Specialist performs various clerical and administrative duties in the billing department, including data entry, information verification, and invoice generation.ESSENTIAL DUTIES AND RESPONSIBILITIES.The essential functions include, but are not limited to,

This essential role interacts closely with firm lawyers, other legal and business staff professionals, and firm clients.

Professional coder certification with credentialing from AHIMA and/or AAPC (RHIA, RHIT, CCS, CCS-P CPC, OR CPC-H) to be maintained annually. Senior Inpatient Medical Coder you. Experience with various encoder systems (eCAC, 3M, EPIC).

We are a privately held, employee-owned company offering superior compensation, benefits, and professional development. GSI is highly respected nationally and internationally for the quality of its professional environmental services and the technically advanced projects it has completed over its ne

USAI) is an ISO 9001:2015 certified, American manufacturer. USAI differentiates itself as a leading designer, manufacturer, and supplier through the innovation, responsiveness, and professionalism of its employees.

Our certified team of experienced staffing professionals uphold a strict code of ethics in the practice of employment law.

A leading staffing firm is seeking a detail-oriented E-Billing Specialist in Houston, TX.The ideal candidate should have over 2 years of e-billing experience in a law firm and proficiency in Juris billing software.Responsibilities include preparing and submitting electronic invoices, maintaining bil

Welcome to the intersection of energy and home services.At NRG, we're all about propelling the next generation of leaders forward.We are driven by our passion to create a smarter, cleaner and more connected future.We deliver innovative solutions that make our customers' lives easier-helping them pow

Reports to: Operations Manager.Location: Corporate Office (Houston, TX) Position Description:.As a critical key member of a reputable Third Party Administrator (TPA) in North Houston, this position is responsible for group benefit administration with multiple lines of coverage.We're looking for an a

Division: Patient Business Services.Location: Hybrid within Greater Houston, TX.Salary Range: $32,355 - $38,065.Work Schedule: Monday - Friday, 8 a.We are seeking a Physician Billing Specialist I who is detail oriented, enjoys working as a team and independently in a fast paced environment as we han

Be among the first 25 applicants.Get AI-powered advice on this job and more exclusive features.This range is provided by DFM & Associates.Your actual pay will be based on your skills and experience talk with your recruiter to learn more.Direct message the job poster from DFM & Associates.A leading i

Accounts Receivable Specialist.Headquartered in the heart of Tennessee, Greenrise Technologies is a full-service green infrastructure firm that delivers innovative, reliable, and precise engineered turnkey systems in the following areas as well operations in a full-service erosion control division:.

Following Maxim established policies and procedures the Billing Specialist accurately and reliably performs the billing process and handles related accounts and documents for assigned locations.Efficiently use various computer systems and tools to enter, extract, and compile the necessary records to

A healthcare revenue cycle management provider in Houston, TX is seeking a Medical Billing and Collections Representative.This role involves managing delinquent medical accounts, assisting patients with payment arrangements, and collaborating with insurance companies.Applicants should possess a high

This position offers comprehensive medical benefits, generous paid time off, and opportunities for professional growth within a mission-driven team.

Collaborate with experienced professionals in the energy sector.

Possess and apply thorough knowledge to all aspects of program billing processes including eligibility, coding, and insurance/payer requirements.Also responsible for accurate and timely grant and other billings and reports as assigned.This is a TEMPORARY Full Time Position.Experience and knowledgeab

McDermott Will & Schulte is a leading global law firm that brings together more than 1,750 lawyers and 3,200 business professionals. We are also certified by Great Place to Work. Base pay is only one part of the Total Rewards that MWE provides to compensate and recognize our staff professionals for

A pediatric non-profit organization is seeking a Billing Specialist in Houston, Texas.The role involves managing insurance claims, communicating with providers, and maintaining client accounts.Candidates should have a high school diploma and at least 3 years of experience in insurance billing.Profic

Address and resolve inquiries from clients and internal stakeholders in a timely and professional manner. Must have a professional, cooperative, and positive attitude.

A healthcare provider in Houston is seeking a dedicated billing professional for their in-office position.

Commercial Refrigeration, Air Conditioning and Commercial Cooking Equipment.What makes us world class? We put our employees first! Hiring great people has made us the best place to work, and we have over 115 years of experience.With 34 offices in the Southeast and over 500 Technicians, we are lookin

Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Must have a CPC, APCC, CMBS, or DRG coder certification. Payment integrity or professional bill re

A leading recruitment firm is seeking a Billing Operations Specialist for a 2-month contract in Houston, TX.This role involves supporting a billing system migration and post-implementation tasks.The ideal candidate will have over 3 years of billing operations experience, particularly in the energy s

Medical Coder Job Duties: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.

A prominent service provider in Houston is seeking a Billing Specialist to manage the final steps of the invoice process.Responsibilities include reviewing quoted pricing, applying vendor costs, and entering customer invoices.Proficiency in Microsoft Office and PDI software is essential.The ideal ca