• Auditor , HCC Risk

    Datavant (Denver, CO)
    …professional, educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review ... standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...bring to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of … more
    Datavant (08/08/25)
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  • Risk Adjustment Clinical…

    UPMC (Pittsburgh, PA)
    UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a full time position ... Auditor /Analyst is an integral part of the Risk Adjustment Department and is responsible for...reviewing and auditing medical records for Hierarchical Condition Category ( HCC ) diagnosis codes for focused claims reviews and government… more
    UPMC (09/30/25)
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  • Sr Coding Compliance Auditor

    Catholic Health Initiatives (Chattanooga, TN)
    …team to support the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition ... Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper...Category ( HCC ) Quality program was developed by CMS to promote… more
    Catholic Health Initiatives (10/04/25)
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  • Analyst, Coding Data Quality Auditor

    CVS Health (IN)
    …auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ( HCC ) required. + CPC ... the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical… more
    CVS Health (10/02/25)
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  • Medical Coding Auditor

    CenterWell (Denver, CO)
    …+ 2 or more years of outpatient coding experience (Preferably in a risk adjustment setting) + Knowledge of various reimbursement methodologies, including ... and help us put health first** The Medical Coding Auditor extracts clinical information from a variety of medical...risk adjustment and fee for service +… more
    CenterWell (10/01/25)
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  • Coding Auditor & Educator

    WelbeHealth (Charleston, WV)
    …education and experience in coding and auditing + Minimum of two (2) years of Risk Adjustment ( HCC ) coding experience in a managed care environment + ... At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate...in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines + Work closely with… more
    WelbeHealth (09/19/25)
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  • Coding Data Quality Auditor

    CVS Health (Oklahoma City, OK)
    …+ Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ( HCC ) preferred. **Education** + ... for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in… more
    CVS Health (09/27/25)
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  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories ( HCC ) coding. Specific duties include performing ... Monitors and reports key performance indicators relative to clinical documentation and HCC coding. . Documents and maintains records of all query, audit, and… more
    WMCHealth (09/12/25)
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  • Quality Senior Analyst

    CVS Health (IL)
    …+ Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ( HCC ) required. + Completion ... + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ( HCC ) required. + Expertise… more
    CVS Health (09/30/25)
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