- Humana (Nashville, TN)
- …and influencing execution of recommended strategy + Experience with Medicare Risk Adjustment and/or medical coding + Understanding of Consumer/Patient ... + Maintains collaborative relationships with internal partners (Provider Engagement, Finance, Medicare Risk Adjustment , Interoperability, Clinical Team,… more
- UCLA Health (Los Angeles, CA)
- … Advantage Risk Adjustment , you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, ... Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Registered...understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems required + Knowledge of Medicare … more
- The Cigna Group (Houston, TX)
- …Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan ... internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise in… more
- CenterWell (Tallahassee, FL)
- …(CMS), other payers, and over government agencies. In addition, the Associate Director, Risk Adjustment oversees all medical coding education activities. The ... understanding of how organization capabilities interrelate across departments. The Associate Director, Risk Adjustment ensures coding is accurate and… more
- 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 + ... Position Location: 100% Remote Qualifications The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis… more
- 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. ... ICD-10-CM Guidelines for Coding and Reporting. **Job Title: HCC Coding Compliance Assistant-KS Plan Advantage- Risk Adjustm** **Location: 100% Remote**… more
- Sharp HealthCare (San Diego, CA)
- …experience working as a certified coder. + 2 Years experience working as a HCC risk adjustment coding auditor. + Experience with medical billing and with ... and diagnostic notes into appropriate levels of care following coding rules and regulations.Applies understanding of Medicare ,...coding principles.Educates clinicians and their staff on the HCC/ Risk Adjustment coding guidelines and… more
- Trinity Health (Fresno, CA)
- …Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing ... and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid… more
- CaroMont Health (Gastonia, NC)
- …Specialists regarding coding guidelines and documentation required to capture HCC's for Risk Adjustment coding . Train and educate coding staff ... 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
- The Cigna Group (Sunrise, FL)
- …experience or direct health plan experience with STARS, HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage requiredAbility ... on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and… more
- The Cigna Group (Seattle, WA)
- …experience or direct health plan experience with STARS, HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage required + ... on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and… more
- Humana (Annapolis, MD)
- …**Required Qualifications** + (CPC) AAPC or AHIMA Coding Certification + 1+ year Risk Adjustment experience + 1+ year Medical record review knowledge + Zoom ... caring community and help us put health first** The Coding Educator 2 identifies opportunities for the North East...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Fairview Health Services (St. Paul, MN)
- …provider documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment , accurate coding , accuracy of patient outcomes, ... informally, regarding the impact of documentation on patient care, quality metrics, risk adjustment , and correct reimbursement. Adheres to departmental and… more
- Insight Global (Tampa, FL)
- …an active Coding certification (CPC) through AAPC or AHIMA, or a CCS. Will be coding more risk adjustment vs profee. Most of the markets are strictly ... Job Description Insight Global is hiring 3 HCC/ Risk Adjustment Certified Professional Coders to...Coders to support a backlog for inpatient and outpatient Medicare advantage projects. Will be expected to meet high… more
- Hackensack Meridian Health (Hackensack, NJ)
- …+ Reviews CDI quality liaison recommendations as it relates to mortality, PSI/HAC, POA and risk adjustment codes and makes changes as needed in compliance with ... coding and grouping errors. + Responsible for re- coding / reviewing consecutive accounts for Medicare 24...Responsible for re- coding / reviewing consecutive accounts for Medicare 24 hour readmit accounts, Medicaid 7 day readmit… more
- Molina Healthcare (Albuquerque, NM)
- …related to activities in all government lines of business impacted by regulatory risk adjustment payment model. Accountable for designing and implementing a ... lead to the overall achievement of improved accuracy, compliancy, and completeness in risk adjustment revenue for all government lines of business. Supports the… more
- Intermountain Health (Las Vegas, NV)
- …leaders, physicians, advanced practice providers (APP), and other staff about documentation and risk adjustment in order to improve the accuracy of the overall ... mentor to leaders, physicians, APP's, and other staff about documentation and risk adjustment . + Reviews medical records documentation for reimbursement,… more
- Banner Health (AZ)
- …career here! **Bring your years of Multi-Specialty - General Medicine (some HCC) Coding ** **experience** with Certified Risk Adjustment Coder (CRC) ... **Primary City/State:** Arizona, Arizona **Department Name:** Coding Ambulatory **Work Shift:** Day **Job Category:** Revenue Cycle Great careers are built at Banner… more
- Humana (Miramar, FL)
- …community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative) travels to provider offices within the region ... a secure system. The records are reviewed by Humana's Coding staff. * Travel in North Miami/Dade and South...FL and surrounding areas The Medical Record Retrieval Representative ( Risk Adjustment Representative): + Travel up to… more
- Bristol Myers Squibb (New Orleans, LA)
- …complex, high cost buy and bill therapy reimbursement experience including: + Coverage, coding , billing and payment + Medicare (NCD, IPPS, OPPS, 340B, etc.) ... Government payer policy, local payer dynamics and coverage policy, complex reimbursement, coding & billing dynamics, and all components of the Cell Therapy ordering… more