• Certified Coder (Outpatient/…

    Molina Healthcare (Buffalo, NY)
    …with Risk Adjustment Data Validation **Preferred License, Certification, Association** + Certified Risk Adjustment Coder - (CRC) + Certified ... to network of providers on how to improve their risk adjustment knowledge as well as provide...of education and experience **Required License, Certification, Association** + Certified Professional Coder (CPC) + Certified more
    Molina Healthcare (07/31/25)
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  • Director, Registered Nurse/ Certified

    Ankura (New York, NY)
    …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
    Ankura (07/22/25)
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  • Risk Adjustment Auditor Educator…

    Trinity Health (Syracuse, NY)
    …EDUCATION, LICENSURE AND EXPERIENCE INCLUDES:** + Risk Adjustment Coding - Certified Risk Adjustment Coder (CRC) required and + Auditing ... Education if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for...- Certified Auditor Certified Professional Medical Auditor (CPMA) required and + Education… more
    Trinity Health (07/18/25)
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  • Risk Adjustment Coding Specialist…

    Trinity Health (Albany, NY)
    …Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **. Certified Risk Adjustment Coder (CRC) required** . ... Partners' confidentiality requirements as they relate to patient information. What a Certified Risk Adjustment Coding Specialist will do: . Review and… more
    Trinity Health (07/31/25)
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  • HCC Risk Adjustment Coder

    Datavant (Albany, NY)
    …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and...**What you will bring to the table:** + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified more
    Datavant (08/01/25)
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  • Coding Team Lead, HCC Risk

    Datavant (Albany, NY)
    …of the coding team. + Reviews rebuttals submitted by coders. Provides education to the coder if the error is correct or sends the rebuttal through the process if ... they agree the coder 's initial coding was correct. + Answers coding questions...**What you will bring to the table:** + AHIMA certified credentials (CCS, CCS-P) or AAPC certified more
    Datavant (08/08/25)
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  • Auditor, HCC Risk Adjustment Coding…

    Datavant (Albany, NY)
    …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and ... standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...+ High school diploma or GED equivalent + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified more
    Datavant (08/08/25)
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  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …to HCC coding in the ambulatory setting with one or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder ... Applicant link Job Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Specific duties… more
    WMCHealth (07/09/25)
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  • Coding Data Quality Auditor

    CVS Health (Albany, NY)
    …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... equal to approximately 1-2 years for CPC. + CPC ( Certified Professional Coder ) or CCS-P ( Certified...codes. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories… more
    CVS Health (08/09/25)
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  • Senior Coding Educator

    Humana (Albany, NY)
    …Degree + Previous experience in Medicare Advantage or Value-Based Care + AAPC CRC ( Certified Risk Adjustment ) Certification + AAPC CDEO ( Certified ... + High school diploma or equivalent + Must hold AAPC CPC ( Certified Professional Coder ) certification + 2 years or more experience with ICD-10 CM guidelines… more
    Humana (08/08/25)
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