- 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
- UCLA Health (Los Angeles, CA)
- …with physician billing and/or coding, required + Three or more years of recent experience in CMS- HCC Risk Adjustment models V24 and V28, required + Three or ... Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding… more
- UCLA Health (Los Angeles, CA)
- …direction. You can do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of ... Risk Adjustment is instrumental in participating in the planning with...projects from end to end + In-depth knowledge of HCC models V24 and V28 + Familiarity with claims… more
- Trinity Health (Columbus, OH)
- …terminology, CPT and ICD-9/10 coding, and subsequent ICD versions. + Expanded knowledge of Risk Adjustment and HCC coding. + Knowledge of payer contracts ... and development opportunities to keep you working at yours. Risk Adjustment Coding Specialist works in a...Care and RAF Scores **Responsibilities** + Completes and submits Medicare Patient Assessment Forms and maintains accurate database of… more
- Henry Ford Health System (Troy, MI)
- …audits including but not limited to coordination, documentation and coding of CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) and ... Year-to-date, month-to-date, and real-time report generation to identify low risk score providers and providers whose HCC ...software programs used for data collection. + Knowledge of Medicare Advantage risk adjustment payment… more
- Healthfirst (NY)
- …Medicaid Services (CMS) practices, policies, and regulations. Expert knowledge of Medicare Risk Adjustment Payment Methodology, HCC , CRG and other ... leadership to analysts and staff in support of all processes related to risk adjustment for Medicaid, Medicare & QHP products. + Direct the communication… more
- VNS Health (Manhattan, NY)
- …records, including ICD 10 CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required + 2 years of experience in ... areas of opportunity to support accuracy clinical documentation. Works with Risk Adjustment and Quality team to identify topics, areas and opportunities for… more
- CVS Health (Overland Park, KS)
- …working with large Medicare claims dataset -Ability to conduct actuarial and risk adjustment (CMS- HCC ) analysis -Excellent oral & written communication ... **What will you do?** + Evaluate the impact of Medicare quality and risk adjustment ...(MSSP and ACO REACH), including but not limited to risk adjustment opportunities, HCC gaps,… more
- 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 ... Thorough knowledge of ICD-10-CM, Medicare , Medicaid, Commercial HCC coding guidelines * Previous experience with Risk... HCC coding guidelines * Previous experience with Risk Adjustment coding is preferred **Fallon Health… more
- Marshfield Clinic (Marshfield, WI)
- …stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the accuracy ... and integrity of risk adjustment data submitted to the Centers for ...Terminology (CPT), and ICD‐9, ICD-10 and Hierarchical Condition Category ( HCC ) coding. **Preferred/Optional:** Bachelor of Science in Nursing. **EXPERIENCE**… 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
- Ankura (Chicago, IL)
- …of regulatory and industry guidance related to medical necessity, utilization management, risk adjustment and clinical documentation requirements + Ability to ... policy review and interpretation. + Conduct "mock" Centers for Medicare and Medicaid Services audits by reviewing cases for...- especially as it related to Hierarchical Condition Coding ( HCC ) and ICD-10 + Conduct independent review of medical… more