- Evolent (Sacramento, CA)
- …The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will ... claims via progress note clinical documentation review. + Ensure compliance and quality for all coding practices...healthcare administration, or a related field. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder)… more
- Abbott (Livermore, CA)
- …in the Heart Failure Division. The Manager of Medical Billing & Coding will lead the strategy, operations, and compliance of Acelis Connected Health's ... medical billing and coding functions. This role ensures accurate, timely, and compliant...and recommends methods for resolution that satisfy regulatory and compliance requirements. + Performs medical chart audits… more
- Humana (Sacramento, CA)
- …about 340+ senior focused primary care centers in 15 states. The Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and ... validate the mitigation of compliance risk across the organization. This team ensures that...healthcare experience in revenue cycle management (related to billing, coding , collections for Medicare and Medicaid claims) + Experience… more
- CVS Health (Sacramento, CA)
- …the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical , behavioral, ... coding and appropriate documentation during the review of medical records. This role requires a strong focus on...up-to-date coding knowledge, including new changes to coding compliance and reimbursement. + Experience with… more
- Humana (Sacramento, CA)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group… more
- Highmark Health (Sacramento, CA)
- … as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines. Assures compliance with the coding ... **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data… more
- CVS Health (Sacramento, CA)
- …+ Thorough knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + Identify and communicate ... efforts. This role plays a critical part in ensuring coding accuracy and data integrity, directly impacting compliance...Minimum of 3 years recent and related experience in medical record documentation review, diagnosis coding , and/or… more
- Sharp HealthCare (San Diego, CA)
- …a certified coder. + 2 years' experience working as an HCC risk adjustment coding auditor. + Experience with medical billing, medical terminology, ... potential compliance risk and notify management immediately.Identifies anomalies in coding .Identifies ways to avoid errors and issues and creates safeguards to… more
- Ventura County (Ventura, CA)
- … guidance to staff on the most difficult coding cases; + Ensures VCMC coding practices are in compliance with ICD-10 CM/PCS and CPT coding guidelines, ... cases; + Provides education to the physicians on documentation requirements to establish medical necessity based on coding guidelines for assignment of accurate… more
- CenterWell (Sacramento, CA)
- **Become a part of our caring community and help us put health first** The Medical Coding Professional extracts clinical information from a variety of medical ... codes (eg, ICD-10-CM, CPT) to patient records. The Medical Coding Professional 2 work assignments are...Acquisitions: + Perform Problem list cleanup (as outlined by compliance ) + Conduct PCO Process training including but not… more