- Premera Blue Cross (Mountlake Terrace, WA)
- …coding within medical records. This position is essential for maintaining the integrity of Risk Adjustment and HCC coding. By leveraging a deep understanding of ... standards (eg, Coding Clinic) that impact financial and operational aspects of risk adjustment coding. + Collaborate and communicate effectively with internal… more
- Trinity Health (Albany, NY)
- … adjustment payment models. . Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers. **Core ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote… more
- Actalent (Paramus, NJ)
- Job Title: GCP Auditor /Senior Auditor , Quality Assurance The GCP Quality Assurance Auditor /Senior Auditor will play a crucial role in ensuring compliance ... and conduct audits of specific clinical processes based on risk . + Perform clinical vendor audits alongside various SMEs...The team consists of four members, including one GCP auditor and one PV auditor . The company… more
- Elevance Health (Norfolk, VA)
- …hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables associates to ... **JR171732 Coding Auditor Sr** CareBridge Health is a proud member...project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates… more
- Amazon (Herndon, VA)
- …(AWS). We are looking for a motivated Health and Safety (H&S) Lead Auditor to drive safety compliance, continuous improvement, and operational excellence across our ... organizational H&S performance - Support the design and delivery of internal auditor training - Earn trust of operations partners through proactive and continuous… more
- Aston Carter (Sioux Falls, SD)
- Job Title: Compliance AuditorJob Description As a Compliance Auditor , you will play a crucial role in supporting the Compliance Leadership team, including the Chief ... performance of internal audits, identify compliance risks, and manage vendor risk processes. Responsibilities + Assist in creating and maintaining compliant… more
- Hackensack Meridian Health (Hasbrouck Heights, NJ)
- …obtain within one (1) year of hire. **Licenses and Certifications Preferred:** + Certified Risk Adjustment Coder (CRAC). If you feel that the above description ... serve as a leader of positive change. The **Physician Billing (PB) Coding Auditor and Educator** is responsible for auditing and educating healthcare providers on… more
- UCLA Health (Los Angeles, CA)
- …and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk -based audits, ... contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide...audit toolkits based on Medicare Advantage and Part D risk areas. * Collaborate with stakeholders and leadership to… more
- WMCHealth (Valhalla, NY)
- …a large multispecialty practice setting, including surgical speacialties is required. HCC Risk adjustment Coding esperience is preferred. Education: High school ... Network Practice Coder/ Auditor Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Clerical/Administrative Support Department: Health Info… more
- CVS Health (Columbia, SC)
- …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... documentation in accordance with all State and Federal regulations and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Proficient in abstraction and assignment of… more
- Dollar Tree (Odessa, TX)
- …Repackages, salvages or destroys according to established guidelines. Provides damage adjustment information to Inventory Control Management. Complies with all FDA, ... policies and procedures. **Safety Conscious:** Does not put self or others at risk of injury. Must be aware of personal responsibility in safety of themselves… more
- Amazon (Redmond, WA)
- …an individual contributor who is creative, and passionate about delivering Governance, Risk and Compliance solutions to meet Leo's regulatory and external assurance ... responsibilities - Design and drive scalable processes within a GRC (Governance, Risk , and Compliance) framework to ensure compliance with Leo's regulatory and… more
- Actalent (Minneapolis, MN)
- …Supplier Corrective Action Requests (SCARs). + Participate in product and process risk management activities. + Participate in Corrective and Preventive Actions as ... Supplier Scorecards and Management techniques highly preferred. + Prior experience as an auditor for both suppliers and internal audits highly preferred. + Lead … more
- Amazon (New York, NY)
- …financial and risk analysis. -Support ongoing actuarial support for outside auditor review of financial estimates and results. -Design studies to monitor the ... reporting and ad-hoc analysis relating to cost of care management -Medicare Risk score projections and premium estimation -Design and implement an actuarially sound… more
- SSM Health (MO)
- …scoring. + Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings. + Maintains knowledge of Centers ... Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical documentation… more
- NCH (Naples, FL)
- …well as applicable organizational policies and procedures. * Experience in MS-DRG and APR-DRGs, risk adjustment , HACs and PSIs, O/E mortality, and LOS. * Working ... assure documentation is clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective of current CMS or… more
- Actalent (St. Louis, MO)
- …fostering a culture of continuous improvement and quality excellence. + Perform risk assessments and implement risk mitigation strategies related to product ... & Qualifications + Certified Quality Engineer (CQE) or Certified Quality Auditor certification preferred. Work Environment This role involves office/desk work, with… more
- WMCHealth (Valhalla, NY)
- …Applicant link Job Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Specific duties ... setting with one or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder certification (CPC), Certified Professional Medical… more
- Actalent (Watertown, CT)
- …bodies, ensuring all processes meet the necessary compliance standards. + Conduct risk assessments to identify potential hazards associated with the medical device ... Quality Engineer (CQE) + Six Sigma Certifications + Lead Auditor certification Job Type & Location This is a...request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due… more
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