• Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    … Advantage Risk Adjustment , you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, ... Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Registered...understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems required + Knowledge of Medicare more
    UCLA Health (11/11/24)
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  • Assistant Director Medicare Advantage…

    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 ... and the manager of coding and education. The Assistant Director of Risk Adjustment will oversee the manager of the coding team and our performance… more
    UCLA Health (11/27/24)
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  • Risk Adjustment Provider Educator…

    The Cigna Group (Houston, TX)
    …Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan ... internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise in… more
    The Cigna Group (11/14/24)
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  • Associate Director, Risk Adjustment

    CenterWell (Tallahassee, FL)
    …(CMS), other payers, and over government agencies. In addition, the Associate Director, Risk Adjustment oversees all medical coding education activities. The ... understanding of how organization capabilities interrelate across departments. The Associate Director, Risk Adjustment ensures coding is accurate and… more
    CenterWell (10/30/24)
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  • HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    …(recent hands-on production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC, CCC HEDIS + ... Position Location: 100% Remote Qualifications The Medical Coder provides coding and coding auditing services directly to providers. This includes the analysis… more
    MedKoder (10/16/24)
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  • PAR - Medical Coding Compliance Specialist

    Medical Mutual of Ohio (Toledo, OH)
    **Job Summary:** Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA ( Medicare Advantage) ... precise medical codes. Audits vendors for quality assurance of risk adjustment coding for ACA...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
    Medical Mutual of Ohio (11/28/24)
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  • Coding Auditor - Finance - Sharp Corporate…

    Sharp HealthCare (San Diego, CA)
    …experience working as a certified coder. + 2 Years experience working as a HCC risk adjustment coding auditor. + Experience with medical billing and with ... and diagnostic notes into appropriate levels of care following coding rules and regulations.Applies understanding of Medicare ,...coding principles.Educates clinicians and their staff on the HCC/ Risk Adjustment coding guidelines and… more
    Sharp HealthCare (11/10/24)
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  • Medicare Provider Performance Enablement…

    The Cigna Group (Sunrise, FL)
    …experience or direct health plan experience with STARS, HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage requiredAbility ... on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and… more
    The Cigna Group (10/03/24)
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  • Onsite Coding Auditor, SAMF Admin CBO…

    Trinity Health (Fresno, CA)
    …Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing ... and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid… more
    Trinity Health (10/02/24)
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  • Ambulatory HCC Coding Educator & Regulatory…

    CaroMont Health (Gastonia, NC)
    …Specialists regarding coding guidelines and documentation required to capture HCC's for Risk Adjustment coding . Train and educate coding staff ... HCC coding issues. Work with payer representatives who audit HCC coding for Managed Medicare plans and participate in the sharing of those audits with staff… more
    CaroMont Health (10/26/24)
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  • Coding Operations Education and Appeals…

    HCA Healthcare (Nashville, TN)
    …(CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) **Benefits** HCA Healthcare offers a total ... staff education. + Understand and communicate nuances of unique coding requirements for major payers such as Medicare... coding requirements for major payers such as Medicare , Medicaid, HMO's, PPO's, IPA's, employers, etc. + Demonstrate… more
    HCA Healthcare (11/23/24)
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  • Coding Provider Educator Professional Fee

    CommonSpirit Health Mountain Region (Centennial, CO)
    …care teams across medical offices to promote accurate clinical documentation and risk adjustment opportunities identified during chart reviews or analytics. ... experience in provider audits, education, and training. + 7 years of experience coding professional fee records. + Knowledge of professional fee coding rules… more
    CommonSpirit Health Mountain Region (11/23/24)
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  • Coding Educator

    Humana (Annapolis, MD)
    …**Required Qualifications** + (CPC) AAPC or AHIMA Coding Certification + 1+ year Risk Adjustment experience + 1+ year Medical record review knowledge + Zoom ... caring community and help us put health first** The Coding Educator 2 identifies opportunities for the North East...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
    Humana (10/29/24)
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  • Outpatient Clinical Documentation Integrity (CDI)…

    Fairview Health Services (St. Paul, MN)
    …provider documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment , accurate coding , accuracy of patient outcomes, ... guidelines, and unanswered queries. + Promotes compliance with CMS, Medicare documentation, and coding and billing regulations....1-2 years coding experience and HCC Capture, Risk Adjustment or Outpatient CDI experience. +… more
    Fairview Health Services (11/26/24)
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  • Business Consultant Sr (Operational)

    Elevance Health (Seven Fields, PA)
    …(Operational)** The Sr. Business Consultant will support the Advanced Primary Care risk adjustment team through vendor engagement, reporting and identifying ... have a healthcare background with a strong understanding of Risk Adjustment . You should have experience in...adjustment and/or health insurance industry. + Experience in Medicare Advantage and Medicaid in a provider based or… more
    Elevance Health (11/21/24)
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  • Diagnosis Related Group Auditor

    Hackensack Meridian Health (Hackensack, NJ)
    …+ Reviews CDI quality liaison recommendations as it relates to mortality, PSI/HAC, POA and risk adjustment codes and makes changes as needed in compliance with ... coding and grouping errors. + Responsible for re- coding / reviewing consecutive accounts for Medicare 24...Responsible for re- coding / reviewing consecutive accounts for Medicare 24 hour readmit accounts, Medicaid 7 day readmit… more
    Hackensack Meridian Health (09/06/24)
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  • Clinical Documentation Specialist

    Intermountain Health (Las Vegas, NV)
    …leaders, physicians, advanced practice providers (APP), and other staff about documentation and risk adjustment in order to improve the accuracy of the overall ... mentor to leaders, physicians, APP's, and other staff about documentation and risk adjustment . + Reviews medical records documentation for reimbursement,… more
    Intermountain Health (11/02/24)
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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) ... **Primary City/State:** Arizona, Arizona **Department Name:** Coding Ambulatory **Work Shift:** Day **Job Category:** Revenue Cycle Great careers are built at Banner… more
    Banner Health (09/21/24)
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  • Medical Records Retrieval Representative

    Humana (Little Rock, AR)
    …and help us put health first** The Medical Records Retrieval Representative ( Risk Adjustment Representative 2) conducts quality assurance audits of medical ... Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 2 performs varied activities and moderately complex… more
    Humana (11/23/24)
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  • Population Perform Analyst Senior

    Novant Health (NC)
    …Quality, Total Cost of Care, Network Integrity, Social Determinants of Health, Risk Adjustment , and Attribution. + Build compelling visualizations, innovative ... performance opportunity identification. + Maintain a working knowledge of Medicare , Medicaid, and commercial insurance products and value-based care incentive… more
    Novant Health (11/27/24)
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