- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... Adjustment Data Validation (RADV) audit and any other chart coding functions, by performing moderately complex...documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …you'll play a critical role in ensuring the accuracy, completeness, and compliance of risk adjustment coding across both internal teams and external ... integrity of our healthcare data. Your Responsibilities * Ensure accuracy and compliance of risk adjustment coding , including the appropriate coding of… more
- Datavant (Honolulu, HI)
- …Experience in building queries to collect and interpret raw data from databases to support risk adjustment coding and medical record + Experience in using ... and aggregate data from multiple data sources for supporting risk adjustment medical record coding ...prevalence and hierarchy + Experience managing data flows for chart retrieval, RA coding , HEDIS abstraction and… more
- Ankura (New York, NY)
- …Risk Adjustment data collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably with a Risk ... Risk Adjustment vendor audit processes, managing retrospective or prospective Risk Adjustment activities such as Chart Review or In-Home Risk … more
- Datavant (Topeka, KS)
- …in complex healthcare environments. + Deep understanding of **HCC coding , chart retrieval, risk adjustment methodologies, and value-based care models** ... chart retrieval and HCC (Hierarchical Condition Category) coding solutions to risk -bearing providers. This role...as a trusted advisor, demonstrating a strong understanding of risk adjustment , HCC coding , and… more
- Datavant (Nashville, TN)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by...to earn up additional incentives, starting at $3.00 per chart based on quality and production.** To ensure the… more
- Hawaii Pacific Health (Honolulu, HI)
- …education to physicians and advanced practice providers (APPs). Previous experience with risk adjustment coding or clinical documentation improvement (CDI). ... years of clinical experience. **Preferred Qualifications:** Certified Professional Coder - Risk Adjustment (CRC) or Certified Documentation Specialist (CCDS).… more
- UPMC (Pittsburgh, PA)
- …Health Plan Network. + Coordinate and present education of providers/practices related to risk adjustment , coding , and clinical documentation improvement. + ... and documentation guidelines. + Analyze medical record documentation and coding through a chart review process that...reports to providers that summarize their performance related to coding and documentation and risk adjustment… more
- Bluestone Physician Services (Stillwater, MN)
- …reviews of patient charts to identify gaps in documentation and opportunities for risk adjustment coding improvement. + Collaborate with Bluestone providers ... support to Bluestone providers to enhance their understanding of risk adjustment coding guidelines and...and documentation best practices. + Maintain accurate records of chart reviews, coding opportunities identified, and outcomes… more
- Good Samaritan (Sioux Falls, SD)
- …and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding , and/or risk adjustment experience is preferred. Currently ... all aspects of workflow are completed. Will review the risk score adjustment information for medical chart record requests and potential medical chart… more
- Intermountain Health (Las Vegas, NV)
- …in the areas of coding and contracting, insurance regulations, and risk adjustment capitated revenue. Nurses review complex clinical provider notes and ... face-to-face or in written communication. + Stay abreast of coding guidelines, risk adjustment payment...+ Demonstrated experience in clinical documentation integrity and/or outpatient coding . + Demonstrated experience in chart reviews… more
- Apex Health Solutions (Houston, TX)
- …(RHIA) Minimum of three (3) years HCC experience performing concurrent and retrospective risk adjustment chart review s required Current AAPC or ... medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment...accurately records all appropriate records and data on assigned chart abstraction projects Ability to meet productivity and accuracy… 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 ... Documentation Integrity Specialist (QI-CDIS) responsibilities include comprehensive secondary clinical chart reviews to identify potential missed opportunities for documentation… more
- CenterWell (Tallahassee, FL)
- …more years of experience as a certified medical coder + Experience with Medicare Risk Adjustment coding **Additional Information** + Remote Role + Standard ... and HCPCS standards. This position utilizes GenAI and advanced coding tools to perform efficient chart reviews,...and advanced coding tools to perform efficient chart reviews, ensure compliance with regulatory guidelines, and optimize… more
- Queen's Health System (Honolulu, HI)
- …completeness of documentation and code assignment for the purposes of appropriate reimbursement, risk adjustment , severity of illness, risk of mortality, ... to ensure the appropriate capture of Comorbid conditions and Major comorbid conditions. * Collaborates with coding staff and quality team to ensure integrity and… more