• Risk Adjustment Coding Coordinator I/II

    Excellus BlueCross BlueShield (Buffalo, NY)
    …ICD-9-CM/ICD-10-CM coding , Medicare Advantage and Commercial Hierarchical Condition Category ( HCC ) coding , and Medicaid Clinical Risk Groups (CRGs) to ensure ... coding validation, monitoring plan specifications, Hierarchical Condition Category ( HCC ) assignment accuracy and Risk Adjustment Validation Audits (RADV). *… more
    Excellus BlueCross BlueShield (05/20/25)
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  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …activities. Monitors and reports key performance indicators relative to clinical documentation and HCC coding . . Documents and maintains records of all query, ... Maintains current competencies in clinical documentation improvement and ICD, CPT and HCC coding through continuing education. Assists with compliance audits and… more
    WMCHealth (04/09/25)
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  • Risk Adjustment Analyst - Mount Sinai Health…

    Mount Sinai Health System (New York, NY)
    …Services - MSH, Mount Sinai Hospital **Responsibilities** * Focuses on Risk Adjustment HCC Coding and Documentation via pre-visit queries to PCPs and ... coding experience ? At least 2 years of HCC Risk Adjustment experience, preferred ? Clinical background in...coding books ? Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation… more
    Mount Sinai Health System (06/21/25)
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  • Risk Adjustment Coding Specialist-Excellus…

    Trinity Health (Syracuse, NY)
    …a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and MEAT (Monitored, ... claim is submitted to payers. . Demonstrate a solid understanding of ICD-10-CM coding and medical terminology, Hierarchical Condition Category ( HCC ), and MEAT… more
    Trinity Health (06/27/25)
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  • Risk Adjustment Trainer

    Datavant (Albany, NY)
    …of medical terminology, medical abbreviations, pharmacology and disease processes + 8+ years coding experience in HCC coding + Knowledge and understanding ... the development of complex and advanced ICD-10 and Hierarchical Condition Category ( HCC ) coding and documentation training programs including defining training… more
    Datavant (05/07/25)
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  • Manager Ambulatory Coding Education and CDI

    Catholic Health (Buffalo, NY)
    …Exempt: Yes Work Schedule: Days Hours: 8-4 Summary: The Manager, Ambulatory Coding Education & Clinical Documentation will be directly responsible for the oversight ... of the Health System's Provider Coding Education Program and the Ambulatory Clinical Documentation Improvement and HCC Risk Diagnosis capture initiatives. The… more
    Catholic Health (06/19/25)
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  • Product Manager, Risk Adjustment Analytics…

    Datavant (Albany, NY)
    …the development of robust, scalable, and actionable analytics that improve coding outcomes, measure product impact, and support value-based client delivery across ... and prospective use cases. + Identify opportunities to improve coding accuracy, efficiency, and transparency through advanced reporting, dashboards, and… more
    Datavant (06/06/25)
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  • Sales Specialist, Diagnostic Oncology (Central…

    Fujifilm (Albany, NY)
    …community. Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers sales through that community. As assigned interface with ... and laboratory staff to provide reimbursement support and test coding . + Development of business plans aligned to strategic...Volume of business (eg, OLT per year, number of HCC cases diagnosed per year, number of hepatologists). +… more
    Fujifilm (05/15/25)
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  • Professional, Risk Adjustment Analyst

    MVP Health Care (Schenectady, NY)
    …opportunities and obstacles. + Measure capture rate of Hierarchical Condition Categories ( HCC )s and diagnosis codes related to Risk Adjustment programs to improve ... + Use Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members. Calculates ROIs for Risk Adjustment programs. + Maintain… more
    MVP Health Care (05/21/25)
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