• Risk Coder

    Brockton Hospital (West Bridgewater, MA)
    …Summary: Under the general supervision of the Ambulatory Coding Manager, and the Senior Risk Coder , the primary function of this position is to ensure accurate ... problem solving and performance monitoring for associates. Works with Senior Risk Coder and Team members to perform Retrospective audits for identified open… more
    Brockton Hospital (12/03/24)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Boston, MA)
    …Certified Professional Biller (CPB), Certified Professional Medical Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC) ... identifying information resources AAPC Coding certification - Certified Professional Coder (CPC) Strong leadership and team management ability Excellent… more
    CVS Health (12/25/24)
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  • Hierarchical Condition Category (HCC) Coding…

    Highmark Health (Boston, MA)
    …and billing **LICENSES or CERTIFICATIONS** **Required** (any of the following) + Certified Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified ... will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act… more
    Highmark Health (12/20/24)
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  • Clinical Document Improvement Specialist

    Fallon Health (Worcester, MA)
    …Coders) of any of the following Certified Coding Specialist (CCS), Certified Risk Adjustment Coding (CRC) or Certified Professional Coder (CPC) required. ... Ensures clinical documentation reflects the level of service, severity of illness, risk of mortality is complete, accurate and successfully facilitates the accurate… more
    Fallon Health (12/26/24)
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  • Fraud Waste and Abuse (FWA) Audit Manager

    Fallon Health (Worcester, MA)
    …updates to various business partners. + Work closely with other clinical and coder teams as well as Medical Directors, as needed. + Make recommendations for ... and/or health insurance, a plus. **License/Certifications:** + Certified Professional Coder (CPC) designation or similar. + Additional certification applicable to… more
    Fallon Health (11/09/24)
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  • Nurse and CPC - Clinical Fraud Investigator II…

    Elevance Health (Woburn, MA)
    …of mutual concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation. **Minimum Requirements:** + ... an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 years related experience, including… more
    Elevance Health (12/31/24)
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