- Commonwealth Care Alliance (Boston, MA)
- …including claims reviews; call center and digital communications reviews; Medicare Risk Adjustment , HCC, clinical and coding reviews; DRG and medical ... leads various quality reviews of claims, Hierarchical Condition Categories (HCC) and clinical coding , call monitoring, system technology upgrades, and other… 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** ... Hours:** 40 **Shift:** Day Shift **Details:** **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works...in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical… more
- CareFirst (Baltimore, MD)
- …Specialist. + Certified Coder (CCS or CPC)-AHIMA or AAPC. **Experience:** 3 years experience in risk adjustment coding , ambulatory coding and/or CRC ... to ensure closure of quality and risk adjustment gaps in care. Consults on proper coding.... + Fulfill various requests for patient charts and clinical information made by the health plan that are… more
- Henry Ford Health System (Troy, MI)
- …adjustment . + Working with appropriate system and revenue cycle leadership, ensures risk adjustment coding representation and participation in appropriate ... clinical revenue optimization. + Monitor and analyze clinical documentation and coding accuracy trends and...benchmarks. + Serves as an internal consultant on HCC coding , risk adjustment , and value-based… more
- The Cigna Group (UT)
- …/ outpatient or medical office coding experience, preferably two (2) years risk adjustment coding experience. + Excellent written and verbal ... matrix partners of Cigna Medicare's programs specific to CMS Risk Adjustment and HCC Coding ...historical and/or real time data. + Develop relationships with clinical providers/staff and communicate coding and documentation… 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 ....Master's Degree or equivalent + BSN/RN preferred or equivalent clinical experience + Five (5) to eight (8) years'… more
- ChenMed (Miami, FL)
- …to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major focus ... related to coding and documentation guidelines for Risk Adjustment Reviews of medical records, patient...our members as well as correct reimbursement. + Identifies clinical coding and documentation trends and training… more
- Somatus (Mclean, VA)
- …lead the execution strategy and implementation of the organization's Risk Adjustment Programs to optimize the programs' clinical benefit, financial accuracy ... + Partner with Finance and Analytics team to establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …This role will be responsible for representing Blue Cross Blue Shield MA's risk adjustment coding improvement initiatives through engagement with health ... maintain collaborative relationships with assigned providers / provider offices to improve risk adjustment coding and documentation accuracy and… 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
- CVS Health (Northbrook, IL)
- …of professional healthcare experience required including some combination of: - Experience in risk adjustment , medical coding , and documentation - Experience ... for an enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna Better Health Plans. Reporting to… more
- Kelsey-Seybold Clinic (Houston, TX)
- …ICD-10-CM Guidelines for Coding and Reporting **Job Title: Supervisor Risk Adjustment & Quality Assurance** **Location: Pearland Administrative Office** ... Coder) or CCS-P (Certified Coding Specialist-Physician), and CRC (Certified Risk Adjustment Coder) Preferred: CPMA (Certified Professional Medical Auditor,… more
- CVS Health (Jackson, MS)
- …The role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical ... record collection, provider collaboration and data sharing, general coding education and related activities, as well as other...experience with one or more of the following methodologies: risk adjustment , clinical quality, or… more
- CVS Health (Atlanta, GA)
- …The role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical ... record collection, provider collaboration and data sharing, general coding education and related activities, as well as other...experience with one or more of the following methodologies: risk adjustment , clinical quality, or… more
- UCLA Health (Los Angeles, CA)
- …compliance officer and the manager of coding and education. The Assistant Director of Risk Adjustment will oversee the manager of the coding team and our ... at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director...We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of… 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 ... preferred (CCS, CPC, or RHIT) Must be credentialed through AAPC or AHIMA. + 2+ years in Risk Adjustment Coding + Experience working in a variety of EMRs and… more
- MedKoder (Mandeville, LA)
- …hands-on production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC, CCC HEDIS + Auditing experience a ... Position Location: 100% Remote Qualifications The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis… more
- Highmark Health (Columbus, OH)
- …as quality and compliance), and/or physicians to identify and deliver high quality and accurate risk adjustment coding . Supports all risk adjustment ... Affordable Care Act (ACA) through Hierarchical Condition Category (HCC) coding , medical coding , clinical terminology...Supports other key objectives to drive capture of accurate risk adjustment coding including documentation… more
- The Cigna Group (Philadelphia, PA)
- …inpatient / outpatient or medical office coding experience, preferably two years risk adjustment coding experience. + Extensive knowledge and adherence ... one of the below):** Certified Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding...clinical providers and staff + Ability to communicate coding and documentation guidelines and education + Conduct provider… 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) ... including but not limited to Hierarchical Condition Category (HCC) Coding , medical coding , clinical terminology...Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation… more