- Cambia Health Solutions, Inc (Portland, OR)
- …detection, and remediation activities. Experience in risk adjustment compliance ( Medicare and ACA) as well as a coding certification is preferred.General ... and other laws. Duties may include, but are not limited to, risk assessment, training, monitoring, auditing, external audit coordination, investigation, root cause… more
- Cambia Health Solutions, Inc (Renton, WA)
- …to drive performance improvements in critical objectives such as population health management, Medicare Stars, and Risk Adjustment .Here are some of the ... Serves as a Subject Matter Expert on MA programs and objectives such as quality, risk adjustment , and other Medicare programs and stays informed and updated… more
- Atrium Health (Charlotte, NC)
- …This leaders will be a key subject matter expert for clinical documentation and risk adjustment coding within the enterprise. This position focuses on ... This clinical position uses clinical/nursing knowledge and understanding of national coding guidelines and standards of compliance to improve overall quality and… more
- Centene Corporation (Raleigh, NC)
- …a medical coder. Required 2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding ). Required Other experience in ... at the provider and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation. + Work in conjunction with… more
- Trinity Health (Fort Lauderdale, FL)
- …and regulations including fraud and abuse and Medicare Hierarchical Condition Coding Risk Adjustment + Excellent analysis and presentation skills ... with vendors, delegated entities, providers and the Centers for Medicare and Medicaid Services (CMS). + Determining resource needs...a leadership role in a capacity developing and implementing risk adjustment , coding , wellness assessment,… more
- Centers Plan for Healthy Living (Brooklyn, NY)
- …skills. + Building relationships + Working knowledge of clinical documentation requirements & Medicare Risk Adjustment coding Preferred: SCOPE ... nursing home reports, logs, medical records, etc + Complete timely health risk assessments + Complete routine monthly comprehensive assessments + Ensures appropriate… more
- Somatus (Mclean, VA)
- Overview The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment ... Finance and Analytics team to establish risk adjustment analytics such as predictive modeling for coding...enrollment etc. + Proven experience with commercial and/ or Medicare Advantage risk adjustment functions.… more
- CVS Health (Jackson, MS)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment ( Medicare ) will be responsible for leading Risk ... Adjustment for the Georgia & the Gulf States Medicare Market, specifically in Mississippi. This role will have...collaboration with the national and local risk adjustment teams, risk coding improvement… more
- CVS Health (Atlanta, GA)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment ( Medicare ) will be responsible for leading Risk ... Adjustment for the Georgia & the Gulf States Medicare Market. This role will have specific responsibility for...collaboration with the national and local risk adjustment teams, risk coding improvement… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** **Description:** ** Risk Adjustment Coding Specialist - CNY AIM (CIN), St. Joseph's Health - Full-time - Remote** ... AIM **Expected Weekly Hours:** 40 **Shift:** Day Shift **Details:** **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a team environment… more
- UCLA Health (Los Angeles, CA)
- …internal and external clients. You will also serve as a Subject Matter Expert for Medicare Advantage risk adjustment . Salary offers are determined based on ... at UCLA Health. As a key leader within our Medicare Advantage team, you will develop and execute of...offices * Required Certified Professional Coder (CPC-I) certification, Certified Risk Adjustment (CRC) coder AAPC certification, and… more
- The Cigna Group (Mclean, VA)
- …Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan ... internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise in… more
- Tufts Medicine (Burlington, MA)
- …Provides education and feedback to physicians on a regular basis in regards to Risk Adjustment Coding guidelines (HCC/DxCG), as well as ICD-10-CM Guidelines ... position performs accurate and timely reviews and validations of Medicare , Medicaid, Commercial HCCs and DxCG's through medical record...coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive… more
- Corewell Health (Grand Rapids, MI)
- …retrieval, and coding . + Follows the strategic direction and implements risk adjustment initiatives required to achieve the business goals and objectives. ... adjustment areas such as, IHA, encounter submissions, risk mitigation, and chart retrieval and coding ....(5) years' experience in the healthcare setting, preferably in Risk Adjustment or Medicare /ACA Operations… more
- Martin's Point Health Care (Portland, ME)
- …is responsible the overall development, refinement, maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior ... Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan...aspects of the decision-making and implementation of medical record coding reviews and coding policies for the… more
- Apex Health Solutions (Houston, TX)
- …AAPC or AHIMA credential required. * Managed Care Experience preferred. * Knowledge of Medicare Risk Adjustment required. SKILLS: * Knowledge of healthcare ... inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment requirements. Reports to: AVP, STARs & … more
- Universal Health Services (Reno, NV)
- …experience + 3+ years in CMS coding and documentation guidelines as well as HCC risk adjustment coding practices + CRC Required. + Additional Coding ... credentialed through AAPC or AHIMA. + 2+ years in Risk Adjustment Coding + Experience...disease processes. + Working knowledge of inpatient admission criteria, Medicare reimbursement system and coding systems preferred,… more
- Martin's Point Health Care (Portland, ME)
- …offers a remote work schedule and 2-4 visits to Maine, per year! Join this dynamic Risk Adjustment Team in our Health Plan which is growing and making an impact! ... Apply today for immediate consideration! The Senior Risk Adjustment Analyst in our Health Plan...of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding +… more
- Randstad US (St. Louis, MO)
- risk adjustment coder. + st louis ,...chasing period. Those charts will be the target of coding . They will also be tasked to support corporate chart ... chasing efforts ( Medicare and Marketplace Pends process and ACA RADV). The...Skills/ Experience: + Certified Professional Medical Auditor + Certified Risk Adjustment Coder + Bachelor's location: Saint… more
- MedKoder (Mandeville, LA)
- …(recent hands-on production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC, CCC HEDIS + ... Position Location: 100% Remote Qualifications The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis… more
