- 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 + Auditing ... Position Location: 100% Remote Qualifications The Medical Coder provides coding and...illnesses into designated numerical codes. This is a full-time, remote position that offers a flexible schedule. Responsibilities: +… more
- Highmark Health (Topeka, KS)
- …degree **Substitutions** + None **Preferred** + None **EXPERIENCE** **Required** + 3 year's in HCC risk adjustment coding experience **Preferred** + 5 year's ... in HCC risk adjustment coding experience **LICENSES or CERTIFICATIONS**...25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Remote Office-based Teaches / trains others regularly Occasionally Travel… more
- Highmark Health (Columbus, OH)
- …partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) ... anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with… more
- Highmark Health (Columbus, OH)
- …medical billing/coding, health insurance, and/or healthcare experience **Preferred** + 1 year of HCC risk adjustment coding **SKILLS** + Critical Thinking + ... with team members, and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) … more
- Martin's Point Health Care (Portland, ME)
- … adjustment operational and strategic planning processes + Subject matter expert in CMS HCC Risk Adjustment modeling + May lead vendor research, software ... 2-4 visits to Maine, per year! Join this dynamic Risk Adjustment Team in our Health Plan...of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding +… more
- Molina Healthcare (Long Beach, CA)
- …Education** Bachelor's Degree in related field **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model + ... Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk … more
- Martin's Point Health Care (Portland, ME)
- …a "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan is responsible the overall development, ... refinement, maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior Director is also responsible for all aspects… more
- CareOregon (Portland, OR)
- …to calculate Centers for Medicaid and Medicare Services (CMS) Hierarchical Condition Category ( HCC ) Risk Adjustment Factor (RAF) models (v24 and v28) ... Job Title Risk Adjustment Analytics Manager Exemption Status...target, full benefits. www.careoregon.org/about -us/careers/benefits Posting Notes This fully remote role is available to candidates residing in Oregon.… more
- Centene Corporation (Raleigh, NC)
- …medical coder. Required 2+ years of experience in coding with knowledge of Medicare risk adjustment ( HCC Coding). Required Other experience in teaching, ... analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Tallahassee, FL)
- …understanding of these guidelines. + Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model. + Ability to meet productivity and accuracy ... most current International Classification of Diseases, Ninth Revision (ICD-10) for CMS risk adjustment purposes. + Codes, abstracts and analyzes inpatient and/or… more
- Highmark Health (Dover, DE)
- …a Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or ... **EXPERIENCE** **Required** + 5-10 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or health related… more
- CVS Health (Columbus, OH)
- …capture. Identifies opportunities to promote quality. Shares best practices in risk adjustment across all sites/regions. Simultaneously manages multiple, complex ... health care more personal, convenient and affordable. Position Summary Remote in the USA. Travel 0-5% in USA. Shift...- CPC AAPC or CCA AHIMA certification- 3+ years risk adjustment experience in Medicare advantage or… more
- Magellan Health Services (Newtown, PA)
- …closely with national and local leadership to drive clinical analytics relative to risk adjustment (Medicare HCC , Medicaid CDPS-Rx), Quality (HEDIS/STARS), ... evaluate healthcare outcomes and performance. This is a fully remote position, allowing you to work from the comfort...matter expertise for one or more of the following: Risk Adjustment for CMS HCC … more
- Providence (Beaverton, OR)
- …Associate Coding Analyst who will:** + Be responsible for detailed diagnostic coding associated with Risk Adjustment and HCC Coding + Impacts revenue and CMS ... + Serve in an advisory role in development of Health Plan Payment Rules to risk adjustment **We welcome 100% remote work for residents who reside in the… more
- The Cigna Group (Philadelphia, PA)
- …+ Working knowledge of CPT/Evaluation and Management guidelines + Working Knowledge of CMS Risk Adjustment and HCC Coding Process + Strong computer skills ... must have in order to do the job:** + ** Remote , Work from Home - must be located in...one of the below):** Certified Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist… more
- CareOregon (Portland, OR)
- …processes + Knowledge of Medicare Advantage bid process + Understanding of various risk adjustment methodologies (eg CDPS+Rx, CMS- HCC , ACG, ERG, MARA) ... Candidates hired for remote positions must reside in Oregon, Washington, Utah,...leadership on potential bid pricing strategies. + Collaborate with Risk Adjustment team to monitor risk… more
- WelbeHealth (Columbus, OH)
- ( Remote , CA residents only) WelbeHealth PACE (All-Inclusive Care...and auditing + Minimum of two (2) years of Risk Adjustment ( HCC ) coding experience ... and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines + Work closely with Coding Supervisor in… more