- Prisma Health (Columbia, SC)
- … teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve ... CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of ...HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, … more
- Premera Blue Cross (Mountlake Terrace, WA)
- …records. This position is essential for maintaining the integrity of Risk Adjustment and HCC coding . By leveraging a deep understanding of ICD-10 and other ... coding errors and documentation deficiencies. In addition to auditing , the Medical Coding Auditor conducts quality assurance (QA) reviews of peer and vendor… more
- CareFirst (Baltimore, MD)
- …day-to-day activities and operational processes of the coding operations team - including HCC coding , auditing and data submission to CMS and other ... activities, and drive ongoing professional development on CMS, HHS, HCC , and ICD-10 coding requirements. + Identify...development on CMS, HHS, HCC , and ICD-10 coding requirements. + Identify and resolve process bottlenecks, ensuring… more
- Datavant (Atlanta, GA)
- …to realize our bold vision for healthcare. We're looking for experienced and credentialed HCC Coding Team Leads to become an integral part of our team. ... to ensure coders are receiving timely feedback. Assists with auditing when the coder has not received recent feedback....+ Extensive knowledge of ICD -10 + 2 years' HCC coding experience + 1+ years' Team… more
- WMCHealth (Valhalla, NY)
- …activities. Monitors and reports key performance indicators relative to clinical documentation and HCC coding . . Documents and maintains records of all query, ... Compliance Auditing Specialist- Remote/Hybrid available Company: NorthEast Provider Solutions...competencies in clinical documentation improvement and ICD, CPT and HCC coding through continuing education. Assists with… more
- Albany Medical Center (Albany, NY)
- …and training to providers and coding staff. Act as an expert for the HCC /Risk adjustment coding . This position is remote but does require onsite education to ... medical record chart reviews (which could include prospective, concurrent & retrospective auditing ) to ensure documentation and selection of HCC diagnosis codes… more
- Genesis Healthcare (PA)
- …documentation that supports and matches accurate and complete billing + Documentation and coding auditing of credentialed LTC ACO providers to identify gaps in ... will be key in assisting with the LTC ACO HCC program ensuring that claims are coded and documented...the maintenance and monitoring of the PAI Medical Group Coding & Billing Compliance Program, conducting auditing … more
- University of Southern California (Alhambra, CA)
- … Denials Management Specialist, and will assist with escalated issues. Essential Duties: + CODING AUDITING * Performs monthly internal coding audits to ... rate as determined by an annual external review of coding . + ABSTRACTING AUDITING * Performs monthly...HCC assignments based on medical necessity documentation & coding of PDx, SecDx, and CPT/HCPCS in accordance with… more
- Humana (Salt Lake City, UT)
- …Qualifications** + 5+ years of experience in risk adjustment coding / auditing /education and provider relations/engagement + Certified Professional Coder ... community and help us put health first** The Senior Coding Educator will work closely with providers to identify...will possess extensive, in-depth and broad knowledge of the HCC risk adjustment methodology gained from actual experience of… more
- Centene Corporation (Jefferson City, MO)
- …chart reviews and advise on clinical best practices related to risk adjustment coding , HCC capture, and documentation improvement. + Performs other duties as ... Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing , and supports Line 1 oversight. Reviews medical records to assess… more
- CVS Health (Austin, TX)
- …1 year recent and related experience in medical record documentation review, diagnosis coding , and/or auditing . + CPC (Certified Professional Coder) or CCS-P ... regulations and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Proficient… more
- Datavant (Boise, ID)
- …RHIA credentials. + Recent experience in academic/level 1 trauma centers + Experience coding and auditing inpatient and outpatient records for various facilities ... will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Skills and Experience * Bachelor's degree * Experience in provider office medical coding , claims auditing , or specialty clinics. * Certifications such as CPMA, ... ensuring the accuracy, completeness, and compliance of risk adjustment coding across both internal teams and external partners. Your...RHIT, RHIA, CCA, CCS. * Expertise in CMS- HCC , and HHS- HCC Risk Adjustment models. Compensation… more
- WMCHealth (Valhalla, NY)
- …the primary function of the position was inpatient and outpatient medical records coding and/or auditing in a large multispecialty practice setting, including ... Job Details: Job Summary: The Coder is responsible for auditing medical records, including applicable diagnoses and operative/ diagnostic...surgical speacialties is required. HCC Risk adjustment Coding esperience is preferred.… more
- Ascension Health (Austin, TX)
- … experience with at least 2 years specific to Medicare Risk Adjustment/ HCC Coding required. + Experience with educating/training/delivering feedback to medical ... providers preferred. + Experience with auditing medical records preferred. + Electronic Healthcare Record (EHR) and Population Health platform/solutions experience… more
- Centene Corporation (Jefferson City, MO)
- …+ 3+ years Audit, risk adjustment and/or compliance required + Risk Adjustment/ HCC coding required + Medicare experience required + Demonstrated understanding ... the Risk Adjustment Compliance program elements, with a focus on the auditing and monitoring functions. Collaborates with business areas to ensure effective… more
