- Elevance Health (Indianapolis, IN)
- ** Risk Adjustment Process Expert I** **Location:** Louisville, KY **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering ... an accommodation is granted as required by law. The ** Risk Adjustment Process Expert** is...adjustment experience strongly preferred. + 3 years of Medicare /Medicaid experience is strongly preferred. + Strong oral, written… more
- Baylor Scott & White Health (Indianapolis, IN)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to decision-makers. This role supports program management activities around risk adjustment data management and submissions to...Participates in the workgroup to resolve encounter data and process issues. + Analysis and forecasting of risk… more
- Datavant (Indianapolis, IN)
- …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Humana (Indianapolis, IN)
- …large production-oriented teams + Experience in claims processing, encounters submissions, or Risk Adjustment + Experience with the IT budgeting and ... and help us put health first** The Associate Vice President (AVP) of Medicare and Medicaid Encounter Submissions is responsible for the integrity, accuracy, and… more
- CVS Health (Indianapolis, IN)
- …codes required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of... and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and… more
- Elevance Health (Indianapolis, IN)
- …complex healthcare datasets highly preferred. + Working knowledge of Risk Adjustment methodologies (eg, HCC, CDPS) and applicable Medicare , Medicaid, and ... + Designs and implements automated tools to support ongoing monitoring of compliance and risk adjustment metrics. + Applies machine learning and NLP methods to… more
- CVS Health (Indianapolis, IN)
- …consulting, financial strategic analysis. + Understanding of value-based care, including risk adjustment methodologies (eg, HCC coding), quality measurement ... the impact of efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas of improvement at a… more