- Excellus BlueCross BlueShield (Buffalo, NY)
- …see is right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of ... diagnosis coding . This position is responsible for risk adjustment coding and quality...Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding , and Medicaid Clinical Risk Groups (CRGs)… more
- Datavant (Albany, NY)
- …and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... Medicare , Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding of health insurance plans operations + Deep… more
- CenterWell (Albany, NY)
- …clinical documentation. + Partner with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, ... provider coding improvement opportunities, risk score trending and tracking. + Partners with MRA...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions.… more
- CenterLight Health System (NY)
- …on current performance. + Serves as a subject matter expert on Risk Adjustment Data Validation (RADV) audits from Medicare . + Perform random audits of ... Manager (CPPM) 4. Certified Professional Biller (CPB) 5. Certified Risk Adjustment Coder (CRC). Experience: + Three...coding /medical billing is required. + Working knowledge of Medicare and Medicaid is required. + Available to travel… more
- Humana (Albany, NY)
- …a focus on learning strategies and adult learning theories + Working knowledge of Medicare Risk Adjustment and/or Stars + Experience using Articulate ... community and help us put health first** Certified Medical Coding Instructor (CPC-I): This is a Senior Learning Design...Information This role will be responsible for supporting the Medicare Risk Adjustment Team within… more
- VNS Health (Manhattan, NY)
- …including ICD 10 CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required + 2 years of experience in ... Licenses and Certifications: + Certified Professional Coder (CPC) or (CRC) Certified Risk Adjustment Coder or Certified Coding Specialist (CCS) required +… more
- Molina Healthcare (Albany, NY)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job Qualifications** **Required… more
- Molina Healthcare (Albany, NY)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), + Diagnosis Related Groups ... lead to value + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job...and other payment mechanisms. * + Understanding of value-based risk arrangements + Experience in quantifying, measuring, and analyzing… more
- VNS Health (Manhattan, NY)
- …membership? "Our analysts are knowledgeable about medical claims data and the risk - adjustment models that determine our revenues; they analyze opportunities for ... examines the drivers of clinical outcomes; analyzes opportunities for managing risk -based populations; evaluates the effectiveness of programs and interventions that… more
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