- Excellus BlueCross BlueShield (Rochester, NY)
- …see is right for you, we encourage you to apply! Job Description: Summary The Risk Adjustment Coding Coordinator is responsible for various aspects of ... diagnosis coding . This position is responsible for risk adjustment coding and quality...validation (RADV) audits. Essential Accountabilities: Level I + Conducts chart reviews and audits utilizing knowledge and experience of… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …professional journey. We invite you to apply today. SUMMARY OF JOB The Certified Risk Adjustment Coding /Audit Reviewer is a physician facing position and ... documentation deficiencies to providers to improve documentation for accurate risk adjustment coding . Knowledge of...has a knowledge of how to read a medical chart and assign the correct diagnosis (ICD-10-CM) codes for… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... Adjustment Data Validation (RADV) audit and any other chart coding functions, by performing moderately complex...documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as… more
- 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
- Datavant (Juneau, AK)
- …experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data ... strategy and execution for Datavant's Retrospective Risk Adjustment Coding products, driving...in collaboration with the Retrieval Product team to streamline chart access for Retrospective Coding Products. Build… 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
- Apex Health Solutions (Houston, TX)
- …(RHIA) EXPERIENCE: . Minimum of three (3) years HCC experience performing retrospective risk adjustment chart review required . Minimum of three ... medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment...accurately records all appropriate records and data on assigned chart abstraction projects . Ability to meet productivity and… more
- Ankura (New York, NY)
- …Risk Adjustment data collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably with a Risk ... Risk Adjustment vendor audit processes, managing retrospective or prospective Risk Adjustment activities such as Chart Review or In-Home Risk … more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director Risk Adjustment and Quality Analytics - Actuarial Location: Hybrid | ... Will Have We are looking for a Director of Risk Adjustment and Quality Analytics to lead...forecasting for Medicare, ACA, and Medicaid. * Oversees diagnostic coding gap identification (suspecting), confidence modeling, and benchmarking. *… more
- Datavant (Nashville, TN)
- …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 (Helena, MT)
- …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
- Avera (Sioux Falls, SD)
- …(CPC) - American Academy of Professional Coders (AAPC) Upon Hire or + Certified Risk Adjustment Coder (CRC) - American Academy of Professional Coders (AAPC) Upon ... education to coders, physicians and hospital department staff on coding and billing findings related to chart ...on coding and billing findings related to chart audits/reviews with detailed reports to track new 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 ... 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 (AZ)
- …providers and office staff. * Provides training and education to provider network regarding risk adjustment and coding updates related to risk ... Office suite/applicable software program(s) proficiency. Preferred Qualifications * Certified Risk Adjustment Coder (CRC). * Certified Professional Payer… more
- The Cigna Group (Bloomfield, CT)
- …and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external ... Job Summary: The Risk Adjustment Quality & Review Analyst...Qualifications: * Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding … more
- Molina Healthcare (Davenport, IA)
- …Association** * Certified Professional in Health Quality (CPHQ) * Nursing License * Certified Risk Adjustment Coding (CRC) To all current Molina employees: ... These functions include, but may not be limited to: chart retrieval strategy, risk adjustment ...not be limited to: chart retrieval strategy, risk adjustment retrieval performance, process effectiveness, market… 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
- 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