Advantmed

Advantmed is a healthcare information management company founded in 2005, specializing in optimizing revenue and improving quality outcomes for health plans and Managed Care Organizations. With a focus on accuracy, efficiency, and transparency, Advantmed offers a suite of services including HEDIS® measure software, risk analytics, and medical record retrieval. The company is dedicated to enhancing the healthcare system and is led by a team of experienced healthcare professionals.

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🔥 Remote - HEDIS Abstractors / HEDIS Reviewers (5158)

Posted 2024-11-22

📍 United States

🧭 Full-Time Seasonal, Part-Time Seasonal

💸 20 - 27 USD per hour

🔍 Healthcare

Minimum of 2 years or 2 seasons of prior work experience in HEDIS abstraction/Review.
Expertise in TRC, PPC, WCC full HEDIS measures sub-measures.
Medical Coder Certification: CPC, CCS, RHIT, RHIA through AAPC or AHIMA or Licensed Nurse: LPN, LVN, RN with an active license.
Must possess a Windows-based laptop or desktop computer and access to a high-speed internet connection.

Under the supervision of the Medical Record Review team, the HEDIS Abstractor conducts data collection and abstraction of medical records for HEDIS projects.
Responsible for reviewing medical records and transferring critical HEDIS data elements into a specified data entry portal.
Maintain accuracy thresholds as set forth by Advantmed.
Comply with HIPAA Laws and regulations.
Attend self-paced recorded training within a defined timeframe for required measures.

Posted 2024-11-22

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🔥 HEDIS Auditor Trainees (5157)

Posted 2024-11-22

📍 United States

🧭 Full-Time Seasonal

💸 25 - 30 USD per hour

🔍 Healthcare

Minimum 2 years/seasons of experience in HEDIS Abstraction / Review.
Medical Coder Certification such as CPC, CCS, RHIT, RHIA through AAPC or AHIMA, OR
Licensed Nurse: LPN, LVN, RN with an active license.

Learn and test on 13 HEDIS measures.
Expectations to pass all 13 measures to gain the necessary knowledge and expertise as auditors.
Complete the trainings assigned each week, including test sets.

Communication SkillsAnalytical SkillsCollaborationProblem SolvingAttention to detailOrganizational skillsTime ManagementMultitaskingDocumentation

Posted 2024-11-22

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🔥 Process Trainer

Posted 2024-11-20

📍 United States

🔍 Healthcare

2+ years of training experience is preferred.
Knowledge of risk adjustment coding for both commercial and Medicare systems.
CPC or CRC credential required; RN or LPN with coding background will also be considered.
Proficient in MS Office programs, including Word, Excel, Outlook, and PowerPoint.
Strong written and oral communication skills, as well as interpersonal skills.
Ability to work independently and collaboratively in a team environment.

Assisting with the development of PowerPoints for NP accuracy.
Providing feedback and coaching to Nurse Practitioners.
Creating content newsletters for NPs.
Handling escalation processes until transitions are offshore.
Answering coding documentation questions.
Communicating with admin team regarding NP attendance.
Conducting onboarding follow-ups with NPs.
Facilitating pilot programs as requested by trainers.
Conducting TH live assessments with Nurse Practitioners.
Preparing medical assistants for pre-visits.
Creating pilot programs for leadership.
Assisting the manager with SOP creation and documentation.
Conducting daily NP interviews and reviewing resumes.
Submitting interview notes and recommendations to HR.

Posted 2024-11-20

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🔥 Quality Control Executive (5151)

Posted 2024-11-19

📍 United States

🔍 Healthcare

A High School Diploma or GED is required.
Must be able to communicate effectively in the English language.
Administrative experience in a work-from-home setting is preferred, especially in back-office roles related to medical records.
Proven customer service experience.
Ability to effectively use computer software and technology including Microsoft Word and Excel.
Knowledgeable about record retrieval processes, policies, and HIPAA regulations.
Ability to read and comprehend simple healthcare terminology.
Effective verbal and written communication skills.
Strong organizational skills are a must.

Understand and recognize valid medical records for each process assigned.
Read valid documents and verify member information considering all possibilities.
Highlight diagnosis and identify the correct page type according to procedure.
Go through respective error reports on a priority basis, understand feedback, and ensure errors do not repeat.
Achieve productivity targets daily for all assigned projects.
Maintain required quality, accuracy, and efficiency consistently across all projects.
Work in a silent environment to improve personal and team performance.
Report job-related events to the supervisor.

Communication SkillsCustomer serviceOrganizational skillsWritten communicationCompliance

Posted 2024-11-19

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🔥 Clinical Coordinator

Posted 2024-11-12

📍 United States

🔍 Healthcare risk adjustment and quality improvement

Minimum 1-3 years of health assessment experience or direct patient care.
Minimum 1-3 years’ experience as team leader, supervisor and/or trainer in a clinical setting.
Knowledge of Power Point and Excel.
Good language/verbal communication skills.
Good written communication skills.
Current NP or RN license in at least one state.

Manage team of Nurse Practitioners performing in-home and telehealth assessments on Medicare Advantage and ACA members.
Provide feedback to Nurse Practitioners on documentation quality and clinical decision-making.
Assist in pilots for new processes to enhance NP and member experience.
Innovate and train on recapturing known diagnoses during assessments.
Collaborate with Coding Account Managers and PHA Training Team for NP training or retraining.
Participate in PHA quality taskforce for GAP closure efforts.
Obtain NP availability based on company needs and membership.
Provide membership numbers/details in providers' areas.
Facilitate tracking for outstanding trainings when non-responsive to training team.
Reduce provider cancellations for appointments.
Coach and identify corrective actions for client/patient complaints.

Communication SkillsCollaborationWritten communicationDocumentationCoaching

Posted 2024-11-12

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🔥 Remote, HCC Medical Coders (5063)

Posted 2024-11-09

📍 United States

🧭 Full-Time

💸 22 USD per hour

🔍 Healthcare

Minimum CPC or CCS certification from AHIMA or AAPC is required.
Higher-level certifications such as CRC are a significant advantage.
Minimum two years of experience in Risk Adjustment and HCC coding in a healthcare setting.
Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology.
Familiarity with electronic health record (EHR) systems and coding software.
Excellent attention to detail and analytical skills.
Ability to work independently.
Strong communication and interpersonal skills for collaboration with medical professionals.
Understanding of compliance and confidentiality regulations, including HIPAA.

Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.
Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines.
Validate and ensure the completeness, accuracy, and integrity of coded data.
Identify and resolve coding discrepancies between clinical documentation and diagnosis coding.
Stay up-to-date with the latest coding guidelines, regulations, and industry best practices.
Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality.
Collaborate with healthcare providers and team members to clarify documentation and resolve queries.
Participate in coding education and training to enhance skills and knowledge.
Prepare and submit reports related to coding activities and accuracy.
Assist in coding audits to ensure quality and compliance of coding practices.
Identify opportunities for process improvement in coding.

Data AnalysisData analysisCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelAttention to detail

Posted 2024-11-09

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🔥 Remote, HCC Medical Coders (5037)

Posted 2024-10-26

📍 United States

🧭 Full-Time

💸 22 USD per hour

🔍 Healthcare

Minimum CPC or CCS certification from AHIMA or AAPC is required.
Higher-level certifications such as CRC (Certified Risk Adjustment Coder) is a significant advantage.
Minimum two years of experience in Risk Adjustment and HCC coding in a healthcare setting.
Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology.
Familiarity with electronic health record (EHR) systems and coding software.
Excellent attention to detail, analytical skills, and ability to work independently.
Strong communication and interpersonal skills for collaboration with medical professionals and team members.
Understanding of compliance and confidentiality regulations, including HIPAA.

Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.
Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines.
Validate and ensure the completeness, accuracy, and integrity of coded data.
Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding.
Stay up-to-date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding.
Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality.
Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries.
Participate in coding education and training programs to enhance coding skills and knowledge.
Prepare and submit reports related to coding activities, coding accuracy, and any coding-related issues or trends.
Assist in internal and external coding audits to ensure the quality and compliance of coding practices.
Identify opportunities for process improvement and efficiency in the coding process.
Offer suggestions to enhance coding documentation and accuracy.

Data AnalysisData analysisCommunication SkillsAnalytical SkillsCollaborationAttention to detail

Posted 2024-10-26

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🔥 PHA Account Manager

Posted 2024-10-21

📍 United States

💸 40000 - 55000 USD per year

🔍 Healthcare

Minimum of 2-3 years of experience in account management, specifically in the healthcare industry.
Strong understanding of healthcare sector regulations.
Excellent communication and interpersonal skills.
Proven ability to manage and grow client relationships.
Strong problem-solving and negotiation skills.
Ability to work both independently and as part of a team.
Proficiency in Microsoft Office Suite and CRM software.
Strong organizational, time management skills and attention to detail.
Ability to travel as needed and handle multiple tasks effectively.
Proactive mindset with a commitment to customer service.
Knowledge of healthcare marketing and sales strategies.

Participate in all implementation client calls.
Support in presenting slides from the Implementation PPT to clients.
Help the Implementation Team on action items.
Review Member Engagement Material and reporting requirements, providing inputs.
Assist with process change discussions and communicate project scope.
Attend weekly client calls and share production plans.
Address client service questions and escalations.
Support the complaint handling process and coordinate with Operations.
Review Project Health and collaborate with Operations on solution presentation.
Manage tasks for timely follow-ups with clients.
Assist in discussions regarding client portal and invoicing.
Participate in discussions about additional volume and prepare client-facing materials.

Project ManagementData AnalysisProject CoordinationData analysisCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelMicrosoft Office Suite

Posted 2024-10-21

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🔥 Record Retrieval Support

Posted 2024-10-21

📍 United States

Proven work experience as an Account Manager, Key Account Manager, Junior Account Manager or similar role.
Ability to communicate, present and influence stakeholders at all levels.
Solid experience with MS Office, especially MS Excel and PowerPoint.
Experience delivering client-focused solutions.
Proven ability to manage multiple account projects with attention to detail.
Excellent listening, negotiation and presentation skills.
Strong verbal and written communication skills.

Serve as the lead point of contact for all client requirement matters.
Build and maintain strong, long-lasting client relationships.
Prepare project plans for successful execution of client projects.
Ensure timely and successful delivery of solutions according to client needs.
Communicate progress of project initiatives to stakeholders.
Develop processes to meet client expectations.
Forecast and track key account metrics.
Prepare reports on project progress.
Initiate early warnings for projects expected to fall behind on SLAs.
Collaborate with teams to meet delivery goals.
Assist with challenging client requests and conduct training.
Liaise with the Product Solutions Team for platform issues.
Represent the Operations Team on client calls.
Prepare weekly project trackers and identify areas of improvement.

LeadershipProject ManagementData AnalysisProject CoordinationCross-functional Team LeadershipOperations ManagementData analysisCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelNegotiation

Posted 2024-10-21

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🔥 Quality Control Executive (5009)

Posted 2024-10-21

📍 United States

🔍 Healthcare

A High School Diploma or GED is required.
Must be able to communicate effectively in the English language.
Administrative experience in work from home, back-office experience in release of information/medical records, or related healthcare experience is preferred.
Proven customer service experience and/or training.
Proficient in Microsoft Word and Excel.
Must understand record retrieval processes, policies, and HIPAA regulations, completing work in compliance.
Ability to read and comprehend simple healthcare terminology.
Effective verbal and written communication skills.
Strong organizational skills are essential.

Understand and recognize valid medical records for assigned processes.
Read valid documents and verify member information.
Highlight diagnosis and identify correct page type per procedure.
Address respective error reports promptly, understand feedback to prevent repetition of errors.
Achieve daily productivity targets across all assigned projects.
Maintain consistent quality, accuracy, and efficiency for all projects.
Contribute to a silent work atmosphere to enhance individual and team performance.
Report job-related events to the supervisor.

Communication SkillsAnalytical SkillsMicrosoft Excel

Posted 2024-10-21

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