- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports prospective risk adjustment via concurrent review and ... supplemental data CMS filing, HHS- Risk Adjustment Data Validation (RADV) audit and...to the required work experience. **Licenses/Certifications:** + CCS-Certified Coding Specialist or CPS, CCS-P, CRC Upon Hire Required or… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST ** **Location:** Trinity Health PACE Corp Michigan ... Administrator thru AHIMA + Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within… more
- Centene Corporation (Tulsa, OK)
- …applicants with either an RN or LPN licensure, and either HEDIS or risk adjustment experience. **Position Purpose:** Support the development and maintenance of ... Risk Adjustment related programs and reporting. Aid in working with Risk Adjustment vendors for programs within all lines of business. + Aid in the… more
- Centene Corporation (Phoenix, AZ)
- …remote from home. Candidate must live in Arizona. **Position Purpose:** Utilize risk adjustment methodologies, principles, and knowledge of managed care ... providers. + Develop collaborative relationships with providers to educate and improve Risk Adjustment coding and documentation competencies. + Use knowledge of… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding ... and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health... Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Registered… more
- The Cigna Group (Houston, TX)
- …of the below): + Certified Professional Coder (CPC) + Certified Risk Adjustment Coder (CRC) + Certified Coding Specialist for Providers (CCS-P) + Registered ... ** Risk Adjustment Provider Educator - Houston**...** Risk Adjustment Provider Educator - Houston** **Must reside in...This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned… more
- Humana (Miramar, FL)
- …caring community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative) travels to provider offices within ... Broward counties, FL and surrounding areas The Medical Record Retrieval Representative ( Risk Adjustment Representative): + Travel up to 50% of the time in North… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …screens and phone, email, and/or Internet activity. + Fast paced environment. #LI-EG1 Adjustment Specialist II M-F 7am-3:30pm LOCATION -- Cincinnati, Ohio 45227 ... supervision of team lead and supervisor, researches and resolves complex adjustment cases and teller transaction discrepancies related to Check, ACE/MICR, Branch… more
- Centene Corporation (Tallahassee, FL)
- …Reporting and has a complete understanding of these guidelines. + Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines. ... the impact of ICD-10 codes on the CMS HCC risk adjustment model. + Ability to meet...required: **Required Certified Professional Coder (CPC):** **Preferred Certified Coding Specialist (CCS):** Pay Range: $22.36 - $38.07 per hour… more
- Mount Sinai Health System (New York, NY)
- …preferred + Credentials in one or more of the following, required: + Certified Coding Specialist (CCS) + Certified Risk Adjustment Coder (CRC) + Certified ... **Job Description** MSHP seeks a Clinical Documentation Specialist who will support efforts to improve the...coding experience + At least 1 year of HCC Risk Adjustment experience, preferred + Clinical background… more
- New York State Civil Service (New York, NY)
- …No Agency Financial Services, Department of Title Financial Crimes Blockchain Analytics Risk Associate (Financial Services Specialist 4 (Financial Crime Risk ... Association of Certified Anti-Money Laundering Specialists: Certified Anti-Money Laundering Specialist , Advanced AML Audit Certification, Advanced Financial Crimes Investigations… more
- New York State Civil Service (New York, NY)
- NY HELP No Agency Financial Services, Department of Title Financial Crime Risk Specialist (Financial Services Specialist 4 (Financial Crime Risk )) ... of Financial Services is seeking candidates for the position of Financial Crime Risk Specialist in the Banking Management unit within the Banking Division.… more
- Trinity Health (Hartford, CT)
- …regulations, compliance and reimbursement, and the effects of coding in relation to risk adjustment payment models + Conduct chart review audits, identify coding ... Local Residency required **Position Purpose** The Clinically Integrated Network (CIN) Risk Coding Specialist is responsible for reviewing medical records… more
- New York State Civil Service (Albany, NY)
- …of Title Virtual Currency Senior Blockchain Analytics Analyst (Financial Services Specialist 2 (Financial Crime Risk ), SG-23) Occupational Category Other ... in one (1) of the following:* Evaluating financial institution financial crime risk (BSA/AML, CIP, OFAC/Sanctions, CTF) in a management, compliance, or audit… more
- Fairview Health Services (St. Paul, MN)
- …(CCS-P), Certified Professional Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist -Outpatient (CCDS-O), Certified Risk Adjustment Coder ... (CCS-P), Certified Professional Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist -Outpatient (CCDS-O), Certified Risk Adjustment Coder… more
- Molina Healthcare (Las Vegas, NV)
- …Specialist , Provider Quality contributes to one or more of these quality improvement/ risk adjustment functions: + Implements key quality and population health ... strategies and risk adjustment , alongside providers and with direction from the Mgr., Provider Quality and Practice Transformation and Health Plan Leadership, to… more
- Veterans Affairs, Veterans Health Administration (Aurora, CO)
- Summary The Supervisory Vocational Rehabilitation Specialist position is located in the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), at ... production schedules and work processes. Develops and revises comprehensive policies, risk management and strategic plans based on feedback from stakeholders,… more
- SSM Health (MO)
- …support an accurateDRGassignment, SOI, and/or ROM.Assists in the mortality review and risk adjustment process utilizing third-party models. + Demonstrates an ... our mission is what sets us apart. The Clinical Documentation Improvement (CDI) specialist is responsible for facilitating the improvement in the overall quality and… more
- RELX INC (Cambridge, MA)
- About the Business: LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
- Sanford Health (Worthington, MN)
- …accreditation and regulatory agency standards preferred. Quality, medical coding, and/or risk adjustment experience is preferred. Currently holds an unencumbered ... area(s) of nursing. Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality improvement… more