- Endeavor Health (Elmhurst, IL)
- …as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service. Position Highlights: Position: ... compliant physician reimbursement and for both evaluation/ management, preventive (HCC risk adjustment ) and surgical services under general supervision.… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- The ** Risk Adjustment & Quality Division at BCBST** is seeking a skilled ** Risk Adjustment Medical Record Coder** to support our mission of ... this role, you will perform first\-pass reviews of member medical records to identify and capture active...accordance with BCBST policy\. **Preferred Qualifications:** + CRC \(Certified Risk Adjustment Coder\) certification is a plus\.… more
- Ascension Health (Elk Grove Village, IL)
- …**Responsibilities** Facilitate improvement in overall quality, completeness and accuracy of medical record documentation. + Complete admission reviews and ... mid-level providers to address the need for more detailed information in the medical record . + Collaborate with healthcare professionals to ensure the severity… more
- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice ... Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects...with RADV Audit responses including managing the collection of medical records , overseeing the selection of … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... (RADV) audit and any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all applicable… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career ... join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at...CMS RADV audits, including retrieval and coding of targeted medical records . * Design and implement QA… more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... oversight. Reviews medical records...complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical… more
- Elevance Health (West Des Moines, IA)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **On-Site Requirement:** **Hybrid 1;** **This role requires associates to be in-office 1 - 2 days ... an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II - Advanced...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- Avera (Sioux Falls, SD)
- …where you matter.** **A Brief Overview** Responsible for activities focused around Risk Adjustment (RA) initiatives and Healthcare Effectiveness Data Information ... Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with...The QRA Specialist will be responsible for ensuring that medical records for identified members are retrieved,… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …a strong background in medical records coding and quality assurance? Risk Adjustment is looking for a **Supervisor** to lead a dynamic team dedicated ... to accuracy and compliance in risk adjustment coding\. **About the Team:** This... records from provider offices and supervise the medical record quality review process\. + Ensure… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST** **Location:** Trinity Health PACE Corp Michigan ... processing. Duties also include abstracting and validating data from medical records and providing education on documentation...+ **Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not… more
- Wolters Kluwer (Austin, TX)
- …| Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/health-language)** **Coder Workbench Solution:** ** Risk Adjustment Software | Health Language ... or Central time zone, have a solid understanding of risk adjustment in the Healthcare Technology space,...role covers all new business, w/ a proven track record of success in sales. **Key Tasks: ** +… more
- Datavant (Topeka, KS)
- …for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ... ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines… more
- Good Samaritan (Sioux Falls, SD)
- …ensure all aspects of workflow are completed. Will review the risk score adjustment information for medical chart record requests and potential ... Experience and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding, and/or risk adjustment experience is preferred.… more
- Mount Sinai Health System (New York, NY)
- …(2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing ... will (1) be responsible for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of practices and… more
- Molina Healthcare (MI)
- …with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer, national Risk Adjustment teams and strategic teams ... **Job Description** **Job Summary** The Director, Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight… more
- Humana (Alachua, FL)
- …of our caring community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative 3) Travels to provider ... system. The records are reviewed by Humana's Coding staff. The Medical Record Retrieval Representative ( Risk Adjustment Representative 3): + Travel… more
- Ventura County (Ventura, CA)
- Workers' Compensation Risk Analyst Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5142408) Apply Workers' Compensation Risk Analyst Salary ... afforded a flexible credit allowance of up to $25,558 annually for purchasing medical , dental, and/or vision insurance from a group of authorized plans. + Flexible… more
- Datavant (Topeka, KS)
- …strategies. The ideal candidate will have a deep understanding of value-based care, risk adjustment , and the healthcare provider ecosystem ( risk -bearing ... as a trusted advisor, demonstrating a strong understanding of risk adjustment , HCC coding, and value-based care...providers (health systems, ACOs, IPAs, etc.). + Proven track record of exceeding sales quotas and driving revenue growth… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Supervisor Medical Records Location: Hybrid | Eagan, Minnesota Career Area: Customer ... is responsible for supervising the people, daily activities, and deliverables of the Medical Record retrieval team within the Value Performance Team. The… more
