Work as a High Risk Disease Detection Specialist

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Founded in 2005, Plaza Medical Centers (PMC) is a primary care physician and management organization that supports patients including Medicare Advantage recipients throughout Southeast Florida. They offer career advancement opportunities, competitive salaries, paid holidays, medical & dental insurance plans, paid time off, indemnity, life and disability benefits.

Job Summary:
The specialist will be responsible for supporting the company risk adjustment program and ensuring risk exposures and opportunities are identified with the key objective of optimizing revenue integrity and accuracy.

This role provides opportunities for learning medical terminology and diagnostic criteria. It is an excellent role for pre-med track students or those in their gap period before medical school. It may be full-time or part-time depending on availability.

The specialist will:

  • Review intensive EMR charts to identify chronic medical conditions.
  • Review hospital records, diagnostic reports, specialist reports and PCP notes to identify medical conditions and supporting materials.
  • Recommend accuracy in documentation and diagnoses.
  • Work with data teams to identify any potential gaps related to risk adjustment.
  • Collaborate with coding staff to identify areas of opportunities in high risk disease detection.

Qualifications and skills:

  • In-depth understanding of medicare risk adjustment and coding guidelines.
  • Understanding of clinical disease definitions and guidelines for identification.
  • Advanced knowledge of risk adjustment compliance and requirements.

To learn more about this opportunity and apply, log into Handshake with your FIU credentials and type in the following keywords: high risk disease. Filter location by Miami, FL.

Deadline to apply is June 30.

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