• SIU Medical Coding Specialist (Hybrid)

    CareFirst (Baltimore, MD)
    …models. Supports to use of alternatives and solutions to maximize quality payments and risk adjustment . Translates from claim language to services in an episode ... Required:** + CCS- Certified Coding Specialist or + Certified Coder (CCS or CPC)-AHIMA or AAPC...or CPC)-AHIMA or AAPC **Experience:** 3 years' experience in risk adjustment coding, ambulatory coding and/or CRC… more
    CareFirst (12/24/25)
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  • Compliance Auditor, MAPD

    UCLA Health (Los Angeles, CA)
    …and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk -based audits, ... contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide...healthcare, or a related field and/or equivalent experience. + Certified Professional Coder (CPC) or Certified more
    UCLA Health (12/12/25)
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  • Coding Data Quality Auditor

    CVS Health (Columbia, SC)
    …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... in medical record documentation review, diagnosis coding, and/or auditing. + CPC ( Certified Professional Coder ) or CCS-P ( Certified Coding… more
    CVS Health (12/28/25)
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  • Senior Director, Revenue Cycle - Clinical…

    Scripps Health (San Diego, CA)
    …of ICD, CPT, and HCPCS coding systems, MS-DRG/APR-DRG methodologies, and risk adjustment /HCC principles. * Strong technical proficiency and experience ... Health Information Administrator) o RHIT (Registered Health Information Technician) o CCS ( Certified Coding Specialist) o CPC ( Certified Professional Coder )… more
    Scripps Health (10/29/25)
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