- Apex Health Solutions (Houston, TX)
- …medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk ... one of the following is required : Certified Professional Coder (CPC) Certified Risk Adjustment Coder (CRC) Certified Coding Specialist (CCS) Registered Health… more
- Highmark Health (Austin, TX)
- …anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with ... at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) risk … more
- Humana (Austin, TX)
- …provider. The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes data and ... leader, tailor's provider group webinars and discussions based on various Risk Adjustment topics. **Use your skills to make an impact** **Required… more
- Deloitte (Dallas, TX)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- Humana (Austin, TX)
- …of experience in root cause analysis, inner working of provider office and systems, or risk adjustment . + Proven ability to compare, read, and report on claims ... related field. + Python, SQL, Databricks, or Power BI experience. + Risk adjustment background or knowledge. + Experience in provider office environments and… more
- Apex Health Solutions (Houston, TX)
- …care teams and their associated practices to drive improvement in clinical quality, risk adjustment and operational efficiency. The PPM is responsible for ... experience A license in one of the following is preferred: Certified Risk Adjustment Coder (CRC) Certified Professional Coder (CPC) Certified Professional… more
- CenterWell (Arlington, TX)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... coaching initiatives are precise + Identify critical issues for high- risk patients during case reviews & other forums, and...as a team + Ensure clinicians effectively co-manage high risk episodes of care and patients with partnered Care… more
- CenterWell (Corpus Christi, TX)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... and coaching initiatives are precise *Identify critical issues for high- risk patients during case reviews & other forums, and...care as a team *Ensure clinicians effectively co-manage high risk episodes of care and patients with partnered Care… 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), ... (APC's), and other payment mechanisms. * Advanced understanding of value-based risk arrangements * Advanced experience in quantifying, measuring, and analyzing… 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 (DRG's), ... (APC's), and other payment mechanisms. * Understanding of value-based risk arrangements + Experience in quantifying, measuring, and analyzing financial,… more
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