- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …required **Work Experience** + Minimum of 2 years of experience in reviewing / retrieving records for Risk Adjustment , and HEDIS projects required + CMS and ... tags medical records into document management system. + Perform onsite medical record review and abstract needed information to be uploaded into BCBSLA… more
- Apex Health Solutions (Houston, TX)
- …Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding ... and compliance with Risk Adjustment requirements. EDUCATION: . High School...complete understanding of their real-world application . Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring… more
- Datavant (Indianapolis, IN)
- …As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate ... representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into… more
- The Cigna Group (Bloomfield, CT)
- …is responsible for day-to-day oversight of a team of Coding Analysts specializing in HHS Risk Adjustment medical record diagnostic coding and quality ... Responsibilities:** + Leads team of certified coding professionals to accurately perform Risk Adjustment medical record reviews and audits, assigning… more
- BlueCross BlueShield of Tennessee (Nashville, TN)
- The Risk Adjustment Medical Record Retrieval team at BCBST is seeing a Medical Record Retrieval Specialist to join our team\. In this role, you ... records \. Preferred candidates will have experience with medical records and Electronic Medical Record system\(s\)\. You will be a great match for… more
- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice ... Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects...with RADV Audit responses including managing the collection of medical records , overseeing the selection of … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... (RADV) audit and any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all applicable… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career ... join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at...CMS RADV audits, including retrieval and coding of targeted medical records . * Design and implement QA… more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... oversight. Reviews medical records...complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location: Hybrid | Eagan, Minnesota Career Area: Special ... Lines The Impact You Will Have The Director of Risk Adjustment is a key leader responsible...opportunities, and evaluation of in-home assessments, in office assessments, medical record retrieval and coding reviews, and… more
- Trinity Health (Columbus, OH)
- …The Risk Adjustment Coder is responsible for reviewing and abstracting medical records to ensure accurate and complete diagnosis coding for risk ... **What You Will Do:** + Reviews and evaluates patient medical records to determine the level of...Collaborate with providers to clarify documentation and educate on risk adjustment coding best practices. + Conduct… more
- Avera (Sioux Falls, SD)
- …where you matter.** **A Brief Overview** Responsible for activities focused around Risk Adjustment (RA) initiatives and Healthcare Effectiveness Data Information ... Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with...The QRA Specialist will be responsible for ensuring that medical records for identified members are retrieved,… more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, to include identifying compliance risks, auditing ... findings to business stakeholders to ensure the quality of risk adjustment data. + Ensure coding accuracy...+ Ensure coding accuracy by reviewing inpatient and outpatient medical records in accordance with International Classification… more
- UNC Health Care (Chapel Hill, NC)
- …improve the health and well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for analyzing and auditing ... medical records retrospectively as requested by insurance...payer under the value care contracts. In addition, the Risk Adjustment Coordinator will be responsible for… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST** **Location:** Trinity Health PACE Corp Michigan ... processing. Duties also include abstracting and validating data from medical records and providing education on documentation...+ **Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not… more
- Datavant (Juneau, AK)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and ... execution for Datavant's Retrospective Risk Adjustment Coding products, driving client data...time taken to execute database queries) + Reduction in records with errors **About You** + **Experience:** 5+ years… more
- Highmark Health (Pittsburgh, PA)
- …a Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or ... appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member...**Required** + 5 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical … more
- Elevance Health (Mason, OH)
- ** 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 responsible for...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- Good Samaritan (Sioux Falls, SD)
- …ensure all aspects of workflow are completed. Will review the risk score adjustment information for medical chart record requests and potential ... Experience and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding, and/or risk adjustment experience is preferred.… more
- Datavant (Topeka, KS)
- …for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ... ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines… more