- 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 hierarchical condition category ( HCC ) coding review for Risk Adjustment staff, contractors, and vendors + Perform audits to… more
- Centene Corporation (Tallahassee, FL)
- …Organization as a medical coder **2+ years of experience** in coding with knowledge of Medicare risk adjustment ( HCC Coding) Required experience in ... record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care.… more
- MedKoder (Mandeville, LA)
- …production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC , CCC HEDIS + Auditing experience ... a PLUS. ICD-10 experience/education a PLUS. About MedKoder, LLC: * Privately held, growing company with strong values and ethics * Professional development and education * All positions are permanent - no contracts or sitting on a "coding bench" * Generous… more
- Highmark Health (Columbus, OH)
- …Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with physicians, team ... to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare ...leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient… more
- The Cigna Group (Bluffton, SC)
- …audit. **Qualifications:** Bachelor's degree or equivalent. **5+ years of experience with Medicare Risk Adjustment -is required.** 5+ years of experience ... coding skills (including ICD-9 and ICD-10), strong knowledge of HCC 's and risk scores, communication and collaborative...Adjustment Data Validation Audits required. Strong knowledge of Medicare Risk Adjustment regulations required.… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment ...+ Three or more years of recent experience in CMS- HCC Risk Adjustment models V24 ... Trainer and Auditor, you will be an expert in risk adjustment coding and documentation, working closely...(II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications, required… 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 ... documentation feedback and submit to Manager for provider education efforts + Update risk adjustment software with all relevant chart review observations + Meet… more
- Evolent Health (Columbus, OH)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The ** Risk Adjustment HCC Coding Support Specialist** at Evolent will be an ... score calculations. **What You Will Be Doing:** As a Risk Adjustment HCC Coding Support...with experience in MSSP ACO programs, Value Based Care, Medicare Advantage and/or commercial risk adjustment… more
- Health First (Rockledge, FL)
- … Risk Adjustment Associates in order to increase awareness of the significance of Medicare Risk Adjustment (MRA) within the CMS Risk Adjustment ... departmental goals and deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human... MA and IFP coding experience with knowledge of Risk Adjustment , CMS and HHS HCC… more
- Tufts Medicine (Burlington, MA)
- …Provides education and feedback to physicians on a regular basis in regards to Risk Adjustment Coding guidelines ( HCC /DxCG), as well as ICD-10-CM Guidelines ... coding meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall… more
- Banner Health (Phoenix, AZ)
- …and develops clinical strategies and educational initiatives around the impact that accurate risk adjustment has on the performance of our MA, MSSP, Medicaid, ... as the clinical DYAD to the Executive Director of Risk Adjustment , co-leading a robust team that...refinement, and implementation of robust provider education programs supporting HCC , HHS, and CDPS+Rx. Can include webinars, on-site sessions,… more
- The Cigna Group (Chattanooga, TN)
- …providers and internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise ... **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program...CPT/Evaluation and Management guidelines. + Working Knowledge of CMS Risk Adjustment and HCC Coding… more
- Sharp HealthCare (San Diego, CA)
- …3 Years experience working as a certified coder. + 2 Years experience working as a HCC risk adjustment coding auditor. + Experience with medical billing and ... medical records review and coding principles.Educates clinicians and their staff on the HCC / Risk Adjustment coding guidelines and makes recommendations for… more
- Robert Half Finance & Accounting (San Antonio, TX)
- …rules, regulations, and ICD-CM coding guidelines, demonstrating an understanding of Medicare HCC coding knowledge. * Participate in monthly coding/documentation ... Description We are seeking an Internal HCC Coding Auditor to join our team in...AHIMA and/or AAPC: Certified Professional Coder (CPC); and/or Certified Risk Adjustment Coder (CRC) preferred. * Proficient… more
- Banner Health (AZ)
- …Multi-Specialty - General Medicine (some HCC ) Coding** **experience** with Certified Risk Adjustment Coder (CRC) certification in an active status, and have ... with General Medicine: Multi-Specialty experience.** This is a skilled team that supports HCC , Hospitalist and Toxicology - and has an opportunity for growth in… more
- Banner Health (LA)
- …coding experience required. Experience normally obtained with 2-3 year experience in CMS HCC Risk Adjustment payment methodology and coding and documentation ... of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG), and Ambulatory Payment Classification...and evaluates trends in DRG (MS-DRG), APC, ACG, DCG, HCC and other Health Risk Adjusted Factors… more
- Trinity Health (Fresno, CA)
- …to local ministry and Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder ... and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge… more