- Centene Corporation (Jefferson City, MO)
- … coding guidelines. + Validate clinical documentation to support appropriate risk adjustment coding , including Hierarchical Condition Categories (HCCs), ... reviews and advise on clinical best practices related to risk adjustment coding , HCC capture,...required and + Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required + NP or… more
- Avera (Sioux Falls, SD)
- … (RA) initiatives and Healthcare Effectiveness Data Information Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with the Director ... providers to ensure that proper clinical documentation. The QRA Specialist will be responsible for ensuring that medical records...do** + Understand the rationale behind Risk Adjustment Work with physicians, clinic staff, coding ,… more
- Corewell Health (Grand Rapids, MI)
- About the Position The Population Health RN - Risk Adjustment Specialist will play a critical role in improving clinical documentation for Hierarchical ... to manage multiple practices and priorities Preferred + Knowledge of HCC coding , risk adjustment , and value-based care model Preferred + Change management… more
- CareFirst (Baltimore, MD)
- …**Education Level:** High School Diploma or GED. **Experience:** 5 years experience in risk adjustment coding , ambulatory coding and/or CRC ... and incentive models. Strategizes alternatives and solutions to maximize quality payments and risk adjustment . Translates from claim language to services in an… more
- Trinity Health (Newtown Square, PA)
- …degree in Medical Field + If RN, Current Registered Nurse License + Certified Coding Specialist (CCS), Certified Clinical Documentation Specialist (CCDS), or ... documentation in the record which impacts HCC or other risk score coding . + Conducts pre and...the outpatient setting required. + Minimum of one year Risk Adjustment Validation experience required. **We offer… more
- Health Care Service Corporation (Mcallen, TX)
- …Experience in health insurance or health care setting + Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail ... on health plan coding initiative guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation. This position… more
- Emanate Health (Covina, CA)
- …**J** **ob Summary** Responsible for the oversight of HCC Program and STAR measures coding related functions. The coding specialist will work with the ... STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0...and achieves or improves upon 4.0 STAR rating. The coding specialist is responsible for education to… 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). ... experience. **Preferred Qualifications:** Certified Professional Coder - Risk Adjustment (CRC) or Certified Documentation Specialist (CCDS). Previous… more
- Ascension Health (Elk Grove Village, IL)
- …/ Registration: + One or more of the following required:* Certified Coding Specialist (CCS) credentialed from the American Health Information ... have the following certification thru AAPC (credentialing board): **Certified Risk Adjustment Coder (CRC) - STRONGLY PREFERRED**...in the CRC program please apply!** + 1 year ** RISK CODING ** experience, preferred (NEW GRADUATES WELCOME)… more
- CenterWell (Tallahassee, FL)
- … leaders/coders) + Partner with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, ... function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible...provider coding improvement opportunities, risk score trending and tracking. + Partners with MRA… more
- HCA Healthcare (Fort Lauderdale, FL)
- …minimal overnight travel. EDUCATION: + Bachelor's Degree preferred. + Must be a Certified Coding Specialist (CCS), Certified Coding Specialist - ... Coder (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and… 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 ... our team as a Part-Time Clinical Documentation Improvement (CDI) Specialist . The primary responsibility of this role is...support to Bluestone providers to enhance their understanding of risk adjustment coding guidelines and… more
- Amazon (Boston, MA)
- …diverse stakeholders; evaluate control effectiveness within AI; understand levels of potential risk and how to address them; provide in-depth consultation; and have ... data to identify patterns, draw conclusions, and prioritize remediation efforts using risk management concepts. Excellent writing skills are required as the output… more
- UTMB Health (Galveston, TX)
- …Coding Associate American Health Information Management (AHIMA) Or CCS - Cert-Cert Coding Specialist American Health Information Management (AHIMA) Or CCS-P - ... Senior Coder - RCO Coding **Galveston, Texas, United States** **New** Business, Managerial...Academy of Professional Coders (AAPC) Or CRC - Cert Risk Adjustment Coder American Academy of Professional… more
- Hackensack Meridian Health (Hasbrouck Heights, NJ)
- …Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); or Certified Professional Coder (CPC) ... a leader of positive change. The **Physician Billing (PB) Coding Auditor and Educator** is responsible for auditing and...year of hire. **Licenses and Certifications Preferred:** + Certified Risk Adjustment Coder (CRAC). If you feel… more
- Mayo Clinic (Rochester, MN)
- …CDI!** Join our team to train providers on documentation best practices and risk adjustment , deliver tailored education, and develop engaging content across Mayo ... business demands. Applies advanced clinical knowledge and expertise from the Certified Coding Specialist (CCS) or CIC certification to accurately assign… more
- Deloitte (Los Angeles, CA)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- SSM Health (MO)
- …support an accurateDRGassignment, SOI, and/or ROM.Assists in the mortality review and risk adjustment process utilizing third-party models. + Demonstrates an ... Regular **Job Highlights:** Must have prior experience as a Clinical Documentation Specialist **Required Qualifications:** + 1 year of experience as a Clinical… 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 ... clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective...a diagnosis. * Acts as a liaison between the Coding Department and the Clinical Documentation Integrity Specialist… more
- WMCHealth (Valhalla, NY)
- …Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding . Specific duties include performing ... Compliance Auditing Specialist - Remote/Hybrid available Company: NorthEast Provider Solutions Inc....concurrent and retrospective reviews of documentation and coding and working with providers and staff to ensure… more