• 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 of 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 Coding

    Trinity Health (Columbus, OH)
    …provide leading education training and development opportunities to keep you working at yours. Risk Adjustment Coding Specialist works in a team environment ... Care and RAF Scores **Responsibilities** + Completes and submits Medicare Patient Assessment Forms and maintains accurate database of..., and subsequent ICD versions. + Expanded knowledge of Risk Adjustment and HCC coding .… more
    Trinity Health (12/19/24)
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  • Health Risk Coding & Education…

    Henry Ford Health System (Troy, MI)
    …including but not limited to coordination, documentation and coding of CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) and vendor ... and Education Specialist - Level II, specific to the Risk Adjustment Coding and Clinical...software programs used for data collection. + Knowledge of Medicare Advantage risk adjustment payment… more
    Henry Ford Health System (12/11/24)
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  • Risk Adjustment Provider Programs…

    Medical Mutual of Ohio (OH)
    Medicare Supplement, and individual plans. _Collaborates with internal departments on risk adjustment coding strategies, HEDIS performance, provider ... the review of provider agreements.** + **Acts as project manager over large internal risk adjustment projects (eg, Optum In Office Assessment program for both MA… more
    Medical Mutual of Ohio (12/06/24)
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  • Medical Coding Compliance Specialist

    Medical Mutual of Ohio (OH)
    Coding Compliance Specialist I** Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and ... precise medical codes. Audits vendors for quality assurance of risk adjustment coding for ACA...coding for ACA (Affordable Care Act) and MA ( Medicare Advantage) with assigning and maintaining diagnoses medical codes.… more
    Medical Mutual of Ohio (12/10/24)
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  • Lead Coding & Education Specialist (Hybrid…

    Henry Ford Health System (Troy, MI)
    …including but not limited to coordination, documentation, and coding of CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) and vendor ... community improve with accurate submission of clinical documentation and coding of risk adjustment data...Become proficient using the Altegra RiskView systems for both Medicare Advantage Risk Adjustment and… more
    Henry Ford Health System (12/11/24)
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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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  • Hierarchical Condition Category (HCC)…

    Highmark Health (Columbus, OH)
    …terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) ... 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… more
    Highmark Health (12/20/24)
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  • Coder - Revenue Cycle Coding

    UTMB Health (Galveston, TX)
    …- Apprentice American Academy of Professional Coders (AAPC) Or CRC - Cert Risk Adjustment Coder American Academy of Professional Coders (AAPC) **Preferred ... Qualifications** PB/HB, Revenue Cycle, Coding , Charge Capture, Medicare , CMS Preferred. **Equal Employment Opportunity** UTMB Health strives to provide equal… more
    UTMB Health (12/03/24)
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  • Coding Educator

    Humana (Trenton, NJ)
    …**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 (12/21/24)
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  • Risk and Quality Provider Educator

    VNS Health (Manhattan, NY)
    …including ICD 10 CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required + 2 years of experience in ... of opportunity to support accuracy clinical documentation. Works with Risk Adjustment and Quality team to identify...Certified Coding Specialist (CCS) or (CRC) Certified Risk Adjustment Coder or Registered Health Information… more
    VNS Health (12/03/24)
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  • CDI Specialist - Managed Care Exp preferred

    Fallon Health (Worcester, MA)
    …regulatory updates * Develop and coordinate education and training that focuses on Risk Adjustment coding and documentation opportunities utilizing a variety ... the following Certified Coding Specialist (CCS), Certified Risk Adjustment Coding (CRC) or...knowledge of ICD-10-CM, Medicare , Medicaid, Commercial HCC coding guidelines * Previous experience with Risk more
    Fallon Health (12/26/24)
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  • Medical Record Retrieval Specialist

    Medical Mutual of Ohio (OH)
    …of life. **Responsibilities** **Medical Record Retrieval Specialist** Supports the company's risk adjustment projects by collaborating with vendors and provider ... offices/facilities to retrieve medical records. Supports other initiatives related to Risk Adjustment Programs (RAPS) and Healthcare Effectiveness Data and… more
    Medical Mutual of Ohio (12/10/24)
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  • HIM Audit and Education Specialist

    Hartford HealthCare (Farmington, CT)
    …documentation to disseminate audit requirements. 6. Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the ... documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding ...five years' work experience with CPT, HCPCS and ICD-10 coding conventions required. Experience with interpreting Medicare ,… more
    Hartford HealthCare (12/27/24)
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  • Revenue Management Educator (Remote Option within…

    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 ... educational and training resource materials to assist providers in coding accuracy. The Educator develops and implements strategic action,...and integrity of risk adjustment data submitted to the Centers for … more
    Marshfield Clinic (12/03/24)
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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 (12/06/24)
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  • Medical Record Retrieval Specialist

    Medical Mutual of Ohio (OH)
    …Advantage, Medicare Supplement, and individual plans. Supports the company's risk adjustment projects by collaborating with vendors and provider ... to retrieve medical records. Supports other initiatives related to Risk Adjustment Programs (RAPS) and Healthcare Effectiveness...Informatics in planning and delivery of reports to close coding and care gaps and improve member outcomes. .… more
    Medical Mutual of Ohio (12/05/24)
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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 (12/14/24)
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