- CareFirst (Baltimore, MD)
- …federal government. Develops and conducts new physician/other healthcare practitioner coding orientation/ education , including group or individual sessions. ... expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** ** Education Level:** Associate's… more
- Trinity Health (Fresno, CA)
- …ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner. Responsible for practitioner education in areas ... procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services… more
- The Cigna Group (Chattanooga, TN)
- …matrix partners of Cigna Medicare's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise in ICD-10-CM/outpatient and CPT ... with providers to assist in achieving accurate and complete coding documentation. Provider Data Lead Analysts will...guidelines. + Working Knowledge of CMS Risk Adjustment and HCC Coding Process. + Strong computer skills… more
- Health First (Rockledge, FL)
- …with Senior Analysts and Value Capture leaders to ensure the quality of coding by Analysts meets department standards and ongoing training efforts. 4. Lead ... and review process. 10. Assist with ongoing training and education of Risk Adjustment Associates in order to increase...the HHS Risk Adjustment model as well as the coding practices set forth by the Risk Adjustment production… more
- Immigration and Customs Enforcement (IN)
- …Service Corps (IHSC), Office of Deputy Assistant Director for Healthcare Compliance ( HCC ), Health Plan Management Unit (HPMU). This is a supervisory position. This ... Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Referral Management Lead (RML) for an assigned regional team and maintains subject matter… more
- J&J Family of Companies (Titusville, NJ)
- …Reimbursement Manager (FRM) is responsible for serving as the primary field-based lead for education , assistance, and issue resolution with healthcare providers ... role involves investing time (up to 50%) on-site with HCPs, assessing their education needs and facilitating collaboration with various stakeholders. **A Day in the… more
- Martin's Point Health Care (Portland, ME)
- …of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding + Recommends tools and methodologies that can be deployed ... adjustment operational and strategic planning processes + Subject matter expert in CMS HCC Risk Adjustment modeling + May lead vendor research, software… more
- CareFirst (Baltimore, MD)
- …is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** ** Education Level:** Bachelor's ... goals are met and propose opportunities in maximizing reimbursement based on the CMS- HCC (Hierarchical Condition Code) model. Perform data mining of claims and data… more
- Banner Health (Phoenix, AZ)
- …Range. CORE FUNCTIONS 1. Creation, refinement, and implementation of robust provider education programs supporting HCC , HHS, and CDPS+Rx. Can include webinars, ... supporting accurate documentation of illness burden. 3. Establish clinical education standards for our coding and PCR...to render appropriate quality of care for members. 9. Lead and develop risk adjustment strategies in parts of… more