- Centene Corporation (Jefferson City, MO)
- … coding guidelines. + Validate clinical documentation to support appropriate risk adjustment coding , including Hierarchical Condition Categories (HCCs), ... current regulatory requirements and best practices. + Perform clinical chart reviews and advise on clinical best practices related...reviews and advise on clinical best practices related to risk adjustment coding , HCC capture,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …you'll play a critical role in ensuring the accuracy, completeness, and compliance of risk adjustment coding across both internal teams and external ... integrity of our healthcare data. Your Responsibilities * Ensure accuracy and compliance of risk adjustment coding , including the appropriate coding of… more
- Datavant (Topeka, KS)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by...plus the option to earn up to $3.25 per chart based on quality and production.** To ensure the… more
- Humana (Salt Lake City, UT)
- …make an impact** **Required Qualifications** + 5+ years of experience in risk adjustment coding /auditing/education and provider relations/engagement + ... gained from actual experience of chronic condition documentation and coding audits, risk adjustment program...as a payment methodology and the importance of proper chart documentation. + Knowledge of EMR interoperability solutions to… more
- Intermountain Health (Montpelier, VT)
- …Adjustment and will learn to demonstrate general proficiency in the areas of Risk Adjustment Coding for highly regulated government insurance programs ... accurate coding practices according to general and risk adjustment coding guidelines as...4. Documents chart review results in a Risk Adjustment database for reporting purposes. 5.… more
- Albany Medical Center (Albany, NY)
- …and training to providers and coding staff. Act as an expert for the HCC/ Risk adjustment coding . This position is remote but does require onsite ... for Coding and Reporting. Code chronic disease that meets HCC and Risk Adjustment criteria. Validate missed coding opportunities. + Conducts professional… more
- Hawaii Pacific Health (Honolulu, HI)
- …education to physicians and advanced practice providers (APPs). Previous experience with risk adjustment coding or clinical documentation improvement (CDI). ... years of clinical experience. **Preferred Qualifications:** Certified Professional Coder - Risk Adjustment (CRC) or Certified Documentation Specialist (CCDS).… more
- Catholic Health Initiatives (Little Rock, AR)
- … for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... and maintain the highest level of ethics in their chart reviews and provider interactions. Use the weekly auditor's...Health Management experience required + Must have experience with risk adjustment coding and value… more
- Bluestone Physician Services (Stillwater, MN)
- …reviews of patient charts to identify gaps in documentation and opportunities for risk adjustment coding improvement. + Collaborate with Bluestone providers ... support to Bluestone providers to enhance their understanding of risk adjustment coding guidelines and...and documentation best practices. + Maintain accurate records of chart reviews, coding opportunities identified, and outcomes… more
- Molina Healthcare (MI)
- …Risk Adjustment , is responsible for the implementation, monitoring, and oversight of all chart collection for Risk Adjustment , RADV, or Risk ... audit projects and deliverables related to accurate billing and coding . This role also works with the Health Plan...healthcare, including at least 4 years in health plan Risk Adjustment or clinical data acquisition/ chart… more
- Good Samaritan (Sioux Falls, SD)
- …and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding , and/or risk adjustment experience is preferred. Currently ... all aspects of workflow are completed. Will review the risk score adjustment information for medical chart record requests and potential medical chart… more
- Amazon (IL)
- …ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and CMS Risk Adjustment guidance. Assign appropriate ICD-10-CM, CPT, and other relevant codes to ... complete chart reviews for Profee and HCC Risk Adjustment * Possesses advanced knowledge and...Possesses advanced knowledge and understanding of Profee and HCC Risk Adjustment , coding and documentation… more
- Intermountain Health (Las Vegas, NV)
- …in the areas of coding and contracting, insurance regulations, and risk adjustment capitated revenue. Nurses review complex clinical provider notes and ... face-to-face or in written communication. + Stay abreast of coding guidelines, risk adjustment payment...+ Demonstrated experience in clinical documentation integrity and/or outpatient coding . + Demonstrated experience in chart reviews… more
- NCH (Naples, FL)
- …well as applicable organizational policies and procedures. * Experience in MS-DRG and APR-DRGs, risk adjustment , HACs and PSIs, O/E mortality, and LOS. * Working ... Documentation Integrity Specialist (QI-CDIS) responsibilities include comprehensive secondary clinical chart reviews to identify potential missed opportunities for documentation… more
- Ascension Health (Austin, TX)
- … experience, preferably in outpatient or primary care settings. + Experience with risk adjustment programs (Medicare Advantage, ACO, ACA HHS, or Medicaid). + ... with coding guidelines and reimbursement reporting requirements. + Conduct chart audits for physician documentation requirements & internal coding ; provides… more
- Geisinger (Danville, PA)
- …Certification is required:CPC - Certified Professional Coder through AAPC CRC - Certified Risk Adjustment Coder through AAPC RHIT - Registered Health Information ... Certified Professional Coder - American Academy of Professional Coders (AAPC); Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC)… more
- SSM Health (MO)
- …reflects the patient's clinical course and complexity to validateaccurate risk - adjustment for administrative metrics used in government incentive/penalty ... on-going support of CDI with extensive collaboration with physicians, nursing, coding , quality, and leadership. + Facilitates improvements to clinical documentation… more
- Centene Corporation (Lansing, MI)
- …Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). + Assists in ... education for HEDIS measures, appropriate medical record documentation and appropriate coding . Assists in resolving deficiencies impacting plan compliance to meet… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- The Risk Adjustment Medical Record Retrieval team at BCBST is seeing a Medical Record Retrieval Specialist to join our team\. In this role, you will be traveling ... basis\. **Job Responsibilities** + Load medical records into BCBST coding system and link records to appropriate chart... coding system and link records to appropriate chart IDs\. + Download medical records from Electronic Medical… more