- CenterWell (Tallahassee, FL)
- …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 ...clinical documentation with the health record. + Ensure medical record documentation is accurate and complete. + Follow… more
- Point32Health (MA)
- …and timely review and validation of Medicare Advantage, Commercial and Medicaid HCCs through medical record reviews. The Risk Adjustment Coding Specialist II ... overall provider documentation and coding. The Risk Adjustment Coding Specialist II will review medical ...Certified Professional Coder (CPC-A, CPC, CPC-H, COC, CIC, or CRC ) certification or Certified Coding Specialist (CCS-P or CCS)… more
- CRC Insurance Services, Inc. (Durham, NC)
- …market our services. + Pre-screening level-funded groups to determine suitable products and risk adjustment factors on premium rates. + Involving BSE as ... the division of TIH Insurance offering the position. TIH offers medical , dental, vision, life insurance, disability, accidental death and dismemberment,… more
- The Cigna Group (Houston, TX)
- …AAPC (at least one of the below): + Certified Professional Coder (CPC) + Certified Risk Adjustment Coder ( CRC ) + Certified Coding Specialist for Providers ... ** Risk Adjustment Provider Educator - Houston**...chart review or providing training/education. + Develop relationships with clinical providers/staff and communicate coding and documentation guidelines. +… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports prospective risk adjustment via concurrent review and supplemental ... data CMS filing, HHS- Risk Adjustment Data Validation (RADV) audit and...any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all… more
- Centene Corporation (Tallahassee, FL)
- … record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...to include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance… more
- UCLA Health (Los Angeles, CA)
- …individual with: + A Certified Professional Coder (CPC) certification and a Certified Risk Adjustment Coder ( CRC ), required + Bachelor's degree (healthcare ... Description As the Medicare Advantage Risk Adjustment Provider Documentation Trainer and...associated with the health plan. You will: + Conduct medical record audits for physicians (MD, DO, or NP)… more
- CDPHP (Albany, NY)
- …CCS/CCS-P or AAPC CPC certification within one year of employment is required. + CRC (Certified Risk Adjustment Coder) credential preferred. + Minimum one ... you to be a part of that experience. The Risk Adjustment Coding Specialist will be responsible...Clinical Documentation Improvement preferred. + Demonstrated knowledge of medical record review and diagnosis coding within the health… more
- Providence (Beaverton, OR)
- …best people, we must empower them._** **Providence Health Plan is calling an** HCC Risk Adjustment QA Auditor: Medicare Advantage & ACA **who will:** + Perform ... internal coding audits of Hhierarchical Condition category (HCC) coding review for Risk Adjustment staff, contractors, and vendors + Perform audits to ensure… 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...+ Abstract and code diagnosis and documentation information + Research and resolution of coding projects as assigned +… more
- Humana (Annapolis, MD)
- …Qualifications** + (CPC) AAPC or AHIMA Coding Certification + 1+ year Risk Adjustment experience + 1+ year Medical record review knowledge + Zoom use and ... assigned provider. The Coding Educator 2 for the North East region reviews medical records and arranges educational sessions with providers aimed at quality of care… more
- Trinity Health (Hartford, CT)
- …regulations, compliance and reimbursement, and the effects of coding in relation to risk adjustment payment models + Conduct chart review audits, identify coding ... Day Shift **Description:** **Position Purpose** The Clinically Integrated Network (CIN) Risk Coding Specialist is responsible for reviewing medical records… more
- The Cigna Group (Bloomfield, CT)
- …Health Information Technician (RHIT) o Registered Health Information Administrator (RHIA) Certified Risk Adjustment Coder ( CRC ) certification Individuals who ... **Job Summary:** The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role,… more
- Kelsey-Seybold Clinic (IA)
- …(Certified Coding Specialist-Physician) or CPC (Certified Professional Coder) or CPC-A or CRC (Certified Risk Adjustment Coder) Preferred: N/A **Special ... and Reporting. **Job Title: HCC Coding Compliance Assistant-KS Plan Advantage- Risk Adjustm** **Location: 100% Remote** **Department:** **KS Plan Advantage- Risk… more
- Catholic Health Initiatives (Chattanooga, TN)
- …the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition Category ... Professional Medical Auditor Certification (CPMA) (CMAS)-preferred but not required. CRC Certification preferred or must be obtained within the first year.… more
- Intermountain Health (Columbus, OH)
- …Qualifications** + National Professional Coding Certification from AHIMA or AAPC + Certified Risk Adjustment Coder ( CRC ) certification from AAPC + 5 ... role will have the responsibility of advising and mentoring caregivers on the Risk Adjustment coding team and ensuring efficient workflow and quality results.… more
- Henry Ford Health System (Troy, MI)
- …RHIT, CPC, CRC , CCS) required. + 1 or more years' experience in HCC/ Risk Adjustment preferred. + Knowledge of ICD-10 and HCC coding guidelines. + Exemplary ... GENERAL SUMMARY: The Outpatient Clinical Documentation Specialist (CDS), in conjunction with physicians,...coding expertise to facilitate the quality and completeness of medical record documentation of outpatient encounters, including but not… 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, ... following, required: o Certified Coding Specialist (CCS) o Certified Risk Adjustment Coder ( CRC ) o... status of patients, current treatment plan, and past medical history to identify potential gaps in clinical… more
- The Cigna Group (Nashville, TN)
- …required (at least one of the below):** Certified Professional Coder (CPC) Certified Risk Adjustment Coder ( CRC ) Certified Coding Specialist for Providers ... / outpatient or medical office coding experience, preferably two years risk adjustment coding experience. + Extensive knowledge and adherence to… more
- Mount Sinai Health System (New York, NY)
- …have a minimum of 3 years coding experience + At least 1 year of HCC Risk Adjustment experience, preferred + Clinical background in a healthcare setting, ... following, required: + Certified Coding Specialist (CCS) + Certified Risk Adjustment Coder ( CRC ) +... status of patients, current treatment plan, and past medical history to identify potential gaps in clinical… more