• HCC Risk Adjustment

    MedKoder (Mandeville, LA)
    …(recent hands-on production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC , CCC HEDIS + Auditing ... Position Location: 100% Remote Qualifications The Medical Coder provides coding and coding auditing services directly...medical record charts for the appropriate coding compliance + Coder is responsible for meeting daily production goal and… more
    MedKoder (10/16/24)
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  • Remote HCC Coder (CPC)

    Insight Global (Tampa, FL)
    Job Description Insight Global is hiring 3 HCC / Risk Adjustment Certified Professional Coders to support a backlog for inpatient and outpatient Medicare ... more risk adjustment vs profee. Most of the markets are strictly risk adjustment focusing on HCC ICD-10 codes only. We do code from the problem list… more
    Insight Global (11/01/24)
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  • HCC Risk Adjustment QA…

    Providence (Beaverton, OR)
    …retain the best people, we must empower them._** **Providence Health Plan is calling an** HCC Risk Adjustment QA Auditor: Medicare Advantage & ACA **who ... + Perform internal coding audits of Hhierarchical Condition category ( HCC ) coding review for Risk Adjustment...and report issues to Supervisor or Director + Provide coder specific education based on audit findings and trends… more
    Providence (10/31/24)
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  • Risk Adjustment Coder II

    Point32Health (MA)
    …here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Under the direction of the Risk Adjustment Supervisor/Manager, performs accurate and timely review and ... Commercial and Medicaid HCCs through medical record reviews. The Risk Adjustment Coding Specialist II reviews provider...Coding Specialist II will lead efforts to evaluate the HCC coding practices and provide analyses and recommendations to… more
    Point32Health (10/09/24)
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  • Complex Coder Physician Practice General…

    Banner Health (AZ)
    …of Multi-Specialty - General Medicine (some HCC ) Coding** **experience** with Certified Risk Adjustment Coder (CRC) certification in an active status, ... **Physi** **cian Practice Coding Team** is looking for an **experienced** **Medical Coder with General Medicine: Multi-Specialty experience.** This is a skilled team… more
    Banner Health (09/21/24)
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  • Risk Adjustment Education Specialist…

    Carle (Urbana, IL)
    …must be maintained with required continuing education (CEUs). within 1 year or Certified Risk Adjustment Coder (AAPC) Certification must be maintained with ... Risk Adjustment Education Specialist - HYBRID...continuing education (CEUs). within 1 year or Certified Professional Coder (AAPC) Certification must be maintained with required continuing… more
    Carle (09/10/24)
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  • Medicare Advantage Risk Adjustment

    UCLA Health (Los Angeles, CA)
    …with: + A Certified Professional Coder (CPC) certification and a Certified Risk Adjustment Coder (CRC), required + Bachelor's degree (healthcare or ... billing and/or coding, required + Three or more years of recent experience in CMS- HCC Risk Adjustment models V24 and V28, required + Three or more years… more
    UCLA Health (08/29/24)
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  • HFHP Associate Risk Adjustment

    Health First (Rockledge, FL)
    *POSITION SUMMARY* This role contributes to Health First Health Plans' (HFHP) Risk Adjustment data collection, supporting compliance with regulatory and ... business. This individual will ensure the integrity of HFHP risk adjustment data by critically analyzing and...Licensure: o None required * Certification: o Certified Professional Coder (CPC) from AAPC or Certified Coding Specialist (CCS)… more
    Health First (10/25/24)
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  • Risk Adjustment Auditor Educator

    Centene Corporation (Tallahassee, FL)
    …medical coder **2+ years of experience** in coding with knowledge of Medicare risk adjustment ( HCC Coding) Required experience in teaching, training or ... record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care.… more
    Centene Corporation (09/25/24)
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  • Coding Data Quality Auditor

    CVS Health (Tallahassee, FL)
    …process and Hierarchical Condition Categories ( HCC ) preferred. + CRC (Certified Risk Adjustment Coder ) preferred. + Excellent analytical and ... the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical… more
    CVS Health (10/26/24)
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  • Clinical Documentation Specialist I - Remote

    Mount Sinai Health System (New York, NY)
    …Must have a minimum of 3 years coding experience o At least 1 year of HCC Risk Adjustment experience, preferred o Clinical background in a healthcare ... following, required: o Certified Coding Specialist (CCS) o Certified Risk Adjustment Coder (CRC) o...CPT, and HCPCS ? Familiarity and understanding of CMS HCC Risk Adjustment coding and… more
    Mount Sinai Health System (10/31/24)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …Health Information Technician (RHIT) + Registered Health Information Administrator (RHIA) + Certified Risk Adjustment Coder (CRC) + Demonstrate high degree ... to develop, implement and manage a detailed and thorough risk adjustment coding education & training program...execution and be familiar with value-based reporting metrics and HCC analysis._ _The Quality Review and Audit Lead Analyst… more
    The Cigna Group (10/22/24)
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  • Quality Review and Audit Analyst(Remote)

    The Cigna Group (Bloomfield, CT)
    …Health Information Technician (RHIT) o Registered Health Information Administrator (RHIA) Certified Risk Adjustment Coder (CRC) certification Individuals who ... **Job Summary:** The Risk Adjustment Quality & Review Analyst... Model to confirm accuracy of Hierarchical Condition Categories ( HCC ) identified from abstracted ICD-10-CM diagnosis codes for the… more
    The Cigna Group (11/02/24)
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  • Risk Coding Specialist for ACO Medical…

    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 ... optimize provider review of conditions **Minimum Qualifications** + Current active Certified Risk Coder (CRC) certification required + Minimum three years… more
    Trinity Health (10/11/24)
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  • Sr Coding Compliance Auditor

    Catholic Health Initiatives (Chattanooga, TN)
    …team to support the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition ... Category ( HCC ) Quality program was developed by CMS to promote...clinicians, and committees as appropriate. + Reports areas of risk directly to the Coding Integrity Manager/Supervisor. + Maintains… more
    Catholic Health Initiatives (10/25/24)
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  • Coding Education Specialist - Philadelphia…

    The Cigna Group (Nashville, TN)
    …(at least one of the below):** Certified Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P) ... Working knowledge of CPT/Evaluation and Management guidelines + Working Knowledge of CMS Risk Adjustment and HCC Coding Process + Strong computer skills (ie… more
    The Cigna Group (09/20/24)
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  • Onsite Coding Auditor, SAMF Admin CBO - Full Time…

    Trinity Health (Fresno, CA)
    …Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing reviews of patient ... for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder 's charge capture and coding with proper International Classification of Diseases… more
    Trinity Health (10/02/24)
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