- University of Michigan (Ann Arbor, MI)
- …of CMS star rating, Vizient, and US News and World Report risk - adjustment systems to identify clinical documentation improvement opportunities. + ... list) DRG assignment, PSI, HAC, SOI, ROM, POA and Risk O:E., risk adjustment and...ROM, Risk and POA assignment. + Evaluate clinical documentation such as signs, symptoms, lab… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Provider Documentation Trainer and Auditor, you will be an expert in risk adjustment coding and ... documentation , working closely with physicians, IPA coders, and risk adjustment teams associated with the health...or more years of experience in providing education to clinical and non- clinical staff, required + Six… more
- Evolent Health (Columbus, OH)
- …the ICD-10-CM Official Coding Guidelines and coding conventions as well as CMS Risk Adjustment Data Validation (RADV) documentation guidelines is applied ... comprehensive review of each progress note to ensure the clinical documentation in the supports the ICD-10...Coding Guidelines and coding conventions as well as CMS Risk Adjustment Data Validation (RADV) documentation… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY * Contribute to Health First Health Plans Risk Adjustment activities that support compliance with regulatory and contractual requirements ... will be responsible for assisting leadership with daily operations pertaining to Risk Adjustment operational activities including but not limited to: executing… more
- Carle (Urbana, IL)
- Risk Adjustment Education Specialist - HYBRID + Department: FCC - Case Mgmt + Entity: FirstCarolinaCare + Job Category: Professional + Employment Type: Full - ... Requirements: None Email a Friend Save Save Apply Now Position Summary: The Risk Adjustment Education Specialist consults with providers and their office staff… more
- CenterWell (Carson City, NV)
- …our caring community and help us put health first** The Associate Director, Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT, ... and over government agencies. In addition, the Associate Director, Risk Adjustment oversees all medical coding education... ensures coding is accurate and properly supported by clinical documentation within the health record. Follows… 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 ... an MRA strategy (eg prospective, retrospective, concurrent approaches). + Lead the risk adjustment operational programs and strategy aimed at monitoring,… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The AVP, Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and Quality ... of business, ensuring alignment of strategy and activities with Enterprise, acting as the Risk Adjustment and Quality subject matter expert for the health plan.… more
- Banner Health (Phoenix, AZ)
- …(PHSO), will serve as the clinical DYAD to the Executive Director of Risk Adjustment , co-leading a robust team that will support the plan and CIN ... strategies and educational initiatives around the impact that accurate risk adjustment has on the performance of...evaluation of how well our provider groups, coders, and clinical decision support tools are supporting accurate documentation… more
- Fallon Health (Worcester, MA)
- …and report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details ... feedback and submit to Manager for provider education efforts + Update risk adjustment software with all relevant chart review observations + Meet… more
- Baylor Scott & White Health (Columbus, OH)
- …audits and creates provider scorecards to offer feedback on Risk Adjustment Methodology + Interprets health record documentation to code and abstracts ... strategies and processes for lines of business subject to risk adjustment . **SALARY RANGE** The pay range...+ Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation + Knowledge of and compliance… 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 ... to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. This… more
- Intermountain Health (Las Vegas, NV)
- …physicians, APC's, and staff, through work in the pre-bill portion of the clinical documentation and coding review and education process. This position ensures ... 2. Develops and presents prepared single and multi-specialty technical and process-based clinical documentation and coding education for physicians, managers and… more
- Mount Sinai Health System (New York, NY)
- …have a minimum of 3 years coding experience o At least 1 year of HCC Risk Adjustment experience, preferred o Clinical background in a healthcare setting, ... **Job Description** MSHP seeks a Clinical Documentation Specialist who will support...following, required: o Certified Coding Specialist (CCS) o Certified Risk Adjustment Coder (CRC) o Certified Professional… more
- Intermountain Health (Las Vegas, NV)
- …is to educate leaders, physicians, advanced practice providers (APP), and other staff about documentation and risk adjustment in order to improve the ... complexity and severity of illness of patients through improved clinical documentation and diagnostic coding practices. **Schedule...mentor to leaders, physicians, APP's, and other staff about documentation and risk adjustment . +… more
- Tufts Medicine (Burlington, MA)
- …improvement in overall quality, completeness, and accuracy of medical record documentation , obtains appropriate clinical documentation through extensive ... as well as assisting in the education and training related to improving clinical documentation . A professional individual contributor role that may direct the… more
- SSM Health (MO)
- …and their commitment to our mission is what sets us apart. The Clinical Documentation Improvement (CDI) specialist is responsible for facilitating the ... improvement in the overall quality and completeness of provider-based clinical documentation in the medical record. This position will be responsible for… more
- Kaleida Health (Buffalo, NY)
- …24040 - KH Patient Financial Services **Job Description:** The Outpatient Clinical Documentation Specialist (CDS) will perform concurrent and retrospective ... billing providers) who submit for professional fee reimbursement. Review clinical documentation for opportunities to improve Provider...is captured to support the level of service rendered, risk adjustment of the patient population, and… more
- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: The Outpatient Clinical Documentation Specialist (CDS), in conjunction with physicians, coders, and clinical staff, will utilize ... results for the organization. The outcome will be documentation that accurately and completely captures the clinical...CCS) required. + 1 or more years' experience in HCC/ Risk Adjustment preferred. + Knowledge of ICD-10… more
- Geisinger (Danville, PA)
- …recommends actionable plans using financial and analytical data prepared by risk adjustment analysts. + Provides consultative support to clinical areas on a ... Identifies process improvement opportunities associated with the management of risk adjustment initiatives. Investigates current processes, assessing efficiency… more