Nurse Medicare Consultant

Convergence is hiring a Medicare Consultant!

Convergence Workforce is a full-service, hassle-free solution for all outsourcing needs. We provide high-quality, cost-effective, and customized, data-driven solutions.

Our company culture is founded on building our employees up, giving them the support to grow in an exciting and driven workplace environment. When you love what you do and you love where you work, it’s hard not to thrive! Our management team is known for being exceptionally communicable, actively seeking input and out-of-the-box creative thinking. Join our expanding team today to experience what it feels like to make a real impact and feel valued today!

The Medicare Consultant is responsible for providing expertise in the area of quality and risk adjustment coding for provider clients. A Medicare Consultant will interface with operational and clinical leadership to assist in identification of operational and clinical best practices in maximizing recapture rates, understanding clinical suspects and monitoring of appropriate clinical documentation and quality coding. The Medicare Consultant will also coordinate the implementation of programs designed to ensure all diagnoses are coded according to CMS and risk adjustment coding guidelines and conditions are properly supported by appropriate documentation in the patient chart. The Medicare Consultant will also ensure that providers understand HEDIS CPTII coding requirements. This position will function in a matrix organization.

Job Responsibilities:

• Assist providers in understanding incentive programs, Medicare STARS and CMS -HCC Risk Adjustment driven payment methodology

• Ensure accurate chart documentation of diagnosis and procedure codes

• Deliver thorough and accurate trainings and consultations on ICD-10 and CPTII codes to providers and appropriate staff
• Educate providers on current billing and documentation practices in accordance with state and federal regulations

Qualifications:

• 1+ years of experience in Risk Adjustment and HEDIS / Stars
  
• 3+ years of clinic or hospital experience and/or managed care experience
• Certified Risk Adjustment Coder or Certified Professional Coder with the American Academy of Professional Coders. Requirement to obtain both certifications, CRC and CPC, within the first year in position (CRC within 6 months of hire and CPC within 1 year of hire).
• Preferred Bachelor's degree in a relevant field
• Knowledge of ICD10-CM coding and EMR
• Advanced proficiency with MS Office (Excel, PowerPoint and Word)
• Excellent Oral and Written communication skills with the ability to deliver group trainings and build long-term relationships

You'll be rewarded and recognized for your performance in an environment that will challenge you! We invest in your career by offering employee development programs and internal growth opportunities.
Sunday-Thursday Israel working hours
To apply: Send resume to [email protected] and specify "Medicare Consultant” in the subject line.