• HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    …production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC , CCC HEDIS + Auditing experience ... a PLUS. ICD-10 experience/education a PLUS. About MedKoder, LLC: * Privately held, growing company with strong values and ethics * Professional development and education * All positions are permanent - no contracts or sitting on a "coding bench" * Generous… more
    MedKoder (10/16/24)
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  • RN Care Coordinator

    Covenant Health Inc. (Knoxville, TN)
    …in care coordination efforts. + Demonstrates knowledge of HEDIS, HCC 's and Medicare Risk Adjustment and their impact on pay-per-performance contracts. + ... Perform other duties as assigned or requested. Qualifications Minimum Education: None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority. Minimum… more
    Covenant Health Inc. (10/23/24)
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  • HCC Coding Compliance Assistant-KS Plan…

    Kelsey-Seybold Clinic (IA)
    …or CPC (Certified Professional Coder) or CPC-A or CRC (Certified Risk Adjustment Coder) Preferred: N/A **Special Skills** Required: Analytical. ... the accurate coding of diagnoses which fall into the HCC model as required by CMS for Medicare...Official ICD-10-CM Guidelines for Coding and Reporting. **Job Title: HCC Coding Compliance Assistant-KS Plan Advantage- Risk Adjustm**… more
    Kelsey-Seybold Clinic (11/05/24)
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  • Remote HCC Coder (CPC)

    Insight Global (Tampa, FL)
    Job Description Insight Global is hiring 3 HCC / Risk Adjustment Certified Professional Coders to support a backlog for inpatient and outpatient Medicare ... vs profee. Most of the markets are strictly risk adjustment focusing on HCC ...HCC codes. These markets are still only reviewing Medicare Advantage members. I would say 20-30% of our… more
    Insight Global (11/13/24)
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  • Ambulatory HCC Coding Educator & Regulatory…

    CaroMont Health (Gastonia, NC)
    …Clinical Documentation Specialists regarding coding guidelines and documentation required to capture HCC 's for Risk Adjustment coding. Train and educate ... HCC coding issues. Work with payer representatives who audit HCC coding for Managed Medicare plans and participate in the sharing of those audits with staff… more
    CaroMont Health (10/26/24)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    …with physician billing and/or coding, required + Three or more years of recent experience in CMS- HCC Risk Adjustment models V24 and V28, required + Three or ... Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding… more
    UCLA Health (11/11/24)
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  • Staff VP Compliance Medicare Operations…

    Elevance Health (Atlanta, GA)
    …Part D and risk adjustment . + Knowledge of Risk Adjustment Payment methodologies and the CMS HCC Model. + Healthcare operations and/or compliance ... **Preferred Skills, Capabilities and Experiences** + Knowledge and understanding of Medicare rules and regulations for program areas including but not limited… more
    Elevance Health (11/06/24)
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  • Risk Adjustment Provider Educator…

    The Cigna Group (Houston, TX)
    …providers and internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise ... **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment &...process, anatomy, and physiology. + Working Knowledge of CMS Risk Adjustment and HCC Coding… more
    The Cigna Group (11/14/24)
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  • Risk Adjustment Analyst

    VNS Health (Manhattan, NY)
    …areas, including Medicaid. + Maintains current knowledge of CMS' Hierarchical Condition Categories ( HCC ) and Prescription Drug Risk Adjustment codes (RxHCCs) ... OverviewSupports initiatives that will impact the Risk Adjustment programs and operations. Collaborates with internal departments and external vendors on risk more
    VNS Health (10/03/24)
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  • Manager, Analytics

    LA Care Health Plan (Los Angeles, CA)
    …care claims Knowledge of Risk Adjustment models (eg CMS Medicare Advantage, HHS- HCC , Medicaid DxCG) Extensive knowledge of healthcare industry, ... Manager, Analytics Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, US, 90017 Position Type: Full… more
    LA Care Health Plan (11/09/24)
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  • Actuary - Accountable Care

    CVS Health (Overland Park, KS)
    …working with large Medicare claims dataset -Ability to conduct actuarial and risk adjustment (CMS- HCC ) analysis -Excellent oral & written communication ... **What will you do?** + Evaluate the impact of Medicare quality and risk adjustment ...(MSSP and ACO REACH), including but not limited to risk adjustment opportunities, HCC gaps,… more
    CVS Health (11/02/24)
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  • Coding Auditor - Finance - Sharp Corporate - Day…

    Sharp HealthCare (San Diego, CA)
    …3 Years experience working as a certified coder. + 2 Years experience working as a HCC risk adjustment coding auditor. + Experience with medical billing and ... medical records review and coding principles.Educates clinicians and their staff on the HCC / Risk Adjustment coding guidelines and makes recommendations for… more
    Sharp HealthCare (11/10/24)
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  • Outpatient Clinical Documentation Integrity (CDI)…

    Fairview Health Services (St. Paul, MN)
    …setting, including physician encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet ... documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment , accurate coding, accuracy of patient outcomes, and… more
    Fairview Health Services (11/16/24)
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  • Complex Coder Physician Practice General Medicine

    Banner Health (AZ)
    …Multi-Specialty - General Medicine (some HCC ) Coding** **experience** with Certified Risk Adjustment Coder (CRC) certification in an active status, and have ... with General Medicine: Multi-Specialty experience.** This is a skilled team that supports HCC , Hospitalist and Toxicology - and has an opportunity for growth in… more
    Banner Health (09/21/24)
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  • Onsite Coding Auditor, SAMF Admin CBO - Full Time…

    Trinity Health (Fresno, CA)
    …to local ministry and Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder ... and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge… more
    Trinity Health (10/02/24)
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