• Hierarchical Condition Category ( HCC

    Highmark Health (Columbus, OH)
    …education, analyzing reports, and identifying process improvements. **ESSENTIAL RESPONSIBILITIES** + Performs HCC coding on projects for MA, ACA, and End Stage ... for Coding and Highmark's Policy and Procedures to guide HCC coding decision making. Maintains RPM coding accuracy and productivity requirements.… more
    Highmark Health (12/20/24)
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  • Manager of HCC Coding and Audit

    R1 RCM (Chicago, IL)
    …flows while reducing operating costs and enhancing the patient experience. As our Manager of HCC Coding and Audit, you will be responsible for overseeing the ... research, answer coding questions, and serve as a subject matter expert in HCC coding compliance. To thrive in this role, you must be coding certified,… more
    R1 RCM (12/18/24)
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  • Risk Adjustment Coding Specialist- Full…

    Trinity Health (Columbus, OH)
    …, and subsequent ICD versions. + Expanded knowledge of Risk Adjustment and HCC coding . + Knowledge of payer contracts and reimbursement. Discovering ... opportunities to keep you working at yours. Risk Adjustment Coding Specialist works in a team environment and is...of submission and payment. + Ensures medical documentation and coding compliance with Federal, State and Private payer regulations.… more
    Trinity Health (12/19/24)
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  • Auditor- Coding , Quality Assurance

    Ascension Health (Indianapolis, IN)
    …with office and hospital based audits 3-5 years preferred Previous experience with surgical case coding would be a plus Experience with HCC /RAF coding would ... and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. +...of records per coder as defined in the system coding audit plan. + Prepare audit reports that are… more
    Ascension Health (12/24/24)
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  • Complex Coder Physician Practice General Medicine

    Banner Health (AZ)
    …career here! **Bring your years of Multi-Specialty - General Medicine (some HCC ) Coding ** **experience** with Certified Risk Adjustment Coder (CRC) certification ... status AHIMA, AAPC** + **at least 3+ years of complex coding experience** + **CRC and/or HCC experience preferred** This is a fully remote position and available… more
    Banner Health (12/14/24)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …documentation and coding , both with Inpatient and Outpatient documentation** + ** HCC coding experience and Risk Adjustment knowledge strongly preferred** + ... Review and Audit Lead Analyst has daily responsibility for coding reviews and audits in support of IFP Risk...the ability to identify the associated Hierarchical Condition Category ( HCC ) codes and associated Service Codes (CPT/HCPCs), as required… more
    The Cigna Group (12/31/24)
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  • CDI Specialist - Managed Care Exp preferred

    Fallon Health (Worcester, MA)
    …* Competent in MS Office * Proven/demonstrated knowledge in the following 1.ICD-10-CM Coding /Risk Adjustment HCC coding 2. Regulatory Compliance 3. HIPAA ... inpatient/outpatient setting * Thorough knowledge of ICD-10-CM, Medicare, Medicaid, Commercial HCC coding guidelines * Previous experience with Risk Adjustment… more
    Fallon Health (12/26/24)
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  • Coding Auditor

    Ascension Health (Kalamazoo, MI)
    …Preferences** CPC certification required, CRC certification preferred; strong background in ICD-10 coding and HCC knowledge. **Why Join Our Team** Ascension ... and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. +...of records per coder as defined in the system coding audit plan. + Prepare audit reports that are… more
    Ascension Health (11/22/24)
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  • Risk Adjustment Reporting and Data Analyst…

    Martin's Point Health Care (NY)
    …of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding . Recommends tools and methodologies that can be deployed ... operational and strategic planning processes . Subject matter expert in CMS HCC Risk Adjustment modeling . May lead vendor research, software installation,… more
    Martin's Point Health Care (12/21/24)
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  • Revenue Management Educator (Remote Option within…

    Marshfield Clinic (Marshfield, WI)
    …of CPT coding rules, ICD‐9 and ICD‐10 codes, Healthcare Common Procedure Coding System (HCPCS) codes, HCC coding , use of modifiers, documentation ... Procedural Terminology (CPT), and ICD‐9, ICD-10 and Hierarchical Condition Category ( HCC ) coding . **Preferred/Optional:** Bachelor of Science in Nursing.… more
    Marshfield Clinic (12/03/24)
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  • Risk and Quality Provider Educator

    VNS Health (Manhattan, NY)
    …+ 5 years' experience in a role that includes subject matter expertise in HCC coding with Inpatient and outpatient medical records, including ICD 10 CM ... of care, HEDIS and STARS measures and accurate ICD coding and accuracy for our members. + Collaborates with...educational resources on best practices for ICD 10 CM Coding , accuracy and Quality measures. + Ensures program content… more
    VNS Health (12/03/24)
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  • Medical Assistant

    Spira Care, LLC (Shawnee, KS)
    coding and documentation for Medical Advantage and Hierarchical Condition Category ( HCC ) coding . Spira Care is an equal opportunity employer. All qualified ... applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability. Spira Care is an advanced primary… more
    Spira Care, LLC (01/01/25)
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  • Practice Coach Office Specialist

    Trinity Health (Muskegon, MI)
    …subject matter expert in additional content areas such as advanced care planning, HCC coding , behavioral health integration, and other key strategic initiatives. ... When serving in this capacity, the Practice Coach-Office Specialist focuses on program development and project management that supports population health alignment, AHN strategic initiatives, and care coordination for Affinia responsible lives. The Practice… more
    Trinity Health (11/27/24)
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  • Inpatient Clinical Documentation Improvement…

    Billings Clinic (Billings, MT)
    …elements including POA,SOI/ROM, ICD10 CM, ICD10 PCS, DRG assignment, and HCC /risk adjusted coding . * Assume responsibility for professional development ... Improvement Coordinator will work in association with the Clinical Documentation Specialists, coding team, physicians, and all members of the healthcare team to… more
    Billings Clinic (11/19/24)
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  • Managing Director - Physician Medical Director,…

    Ankura (Chicago, IL)
    …and + Diagnosis Coding - especially as it related to Hierarchical Condition Coding ( HCC ) and ICD-10 + Conduct independent review of medical records + ... of medical records, the determination of medical necessity and appropriate medical coding , and the computation of financial impacts that may lead to repayments.… more
    Ankura (12/17/24)
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  • HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    Position Location: 100% Remote Qualifications The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis ... and code diagnosis and documentation information + Research and resolution of coding projects as assigned + Document requested information from the medical record… more
    MedKoder (10/16/24)
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  • Risk Coder

    Brockton Hospital (West Bridgewater, MA)
    …have an advanced level knowledge of medical terminology and working knowledge of ICD-10-CM coding conventions and HCC and risk adjust coding guidelines, be ... of our patients. Position Summary: Under the general supervision of the Ambulatory Coding Manager, and the Senior Risk Coder, the primary function of this position… more
    Brockton Hospital (12/03/24)
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  • Sr Coding Compliance Auditor

    Catholic Health Initiatives (Chattanooga, TN)
    …hospital, connect with us today! **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper ... coding with an emphasis on documentation, coding ...efforts across the medical group. The Hierarchical Condition Category ( HCC ) Quality program was developed by CMS to promote… more
    Catholic Health Initiatives (12/23/24)
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  • Home Care Physician - Minneapolis - Sign-On…

    The Cigna Group (Bloomfield, CT)
    …order to ensure patient's medical well-being and to provide accurate data for HCC (Hierarchical Condition Categories) coding , STAR ratings and reimbursement. + ... ENHB In Home Primary Care Program (Model 2): health plans look to us to conduct in-home longitudinal care for medically complex patients with chronic illnesses in an effort improve clinical outcomes. Our team collaborates with the patients' primary care… more
    The Cigna Group (12/31/24)
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  • Risk Adjustment Coding Specialist

    VNS Health (Manhattan, NY)
    coding accuracy. This requires advanced knowledge, certifications, and experience related to coding /auditing of ICD 10 Diagnoses based on HCC category. + ... OverviewIdentifies, collects, assesses, monitors and documents ICD-10 diagnoses based coding information as it pertains to CMS Hierarchical Condition Categories (… more
    VNS Health (01/01/25)
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