- Datavant (Austin, TX)
- …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
- Humana (Austin, TX)
- …for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 3 ensures coding is accurate and properly ... caring community and help us put health first** The Risk Adjustment Representative 3 conducts quality assurance...as well as internal policies and guidelines while analyzing coding information and medical records. May participate in provider… more
- CenterWell (Austin, TX)
- …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
- Humana (Austin, TX)
- …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
- Kelsey-Seybold Clinic (Pearland, TX)
- …or CPC (Certified Professional Coder) or CPC-A or CRC (Certified Risk Adjustment Coder) Preferred: N/A **Special Skills** Required: Analytical. ... detail. Efficient. Flexibility. High work ethic. Team building. Preferred: Knowledge of Medicare and other government or third-party coding rules. Working… more
- Apex Health Solutions (Houston, TX)
- …Current AAPC or AHIMA credential required. Managed Care Experience preferred. Knowledge of Medicare Risk Adjustment required. About Apex Health Solutions ... inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment...ensure proper ICD-10 coding and compliance with risk adjustment requirements. Essential Duties and Responsibilities… more
- Centene Corporation (Houston, TX)
- …closing health care gaps for patients + 3+ years of working directly with HEDIS measure, Medicare STAR ratings, and Risk Adjustment knowledge - 90% of role ... regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment . Provides education for HEDIS measures, appropriate medical… more
- Molina Healthcare (Dallas, TX)
- …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 (TX)
- …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
- CenterWell (Austin, TX)
- …rehab + Previous experience working in/with the primary care setting + Risk adjustment experience + Auditing experience + Coding background + Ability to work ... knowledge + Health Plan experience working with large carriers + Previous Medicare /Medicaid experience a plus + Previous experience in chronic disease management,… more
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