• Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …improvement activities. Monitors and reports key performance indicators relative to clinical documentation and HCC coding. . Documents and maintains records of ... and educational efforts. Tracks and reports on the effectiveness of the clinical documentation improvement program through record keeping and results analysis. .… more
    WMCHealth (09/12/25)
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  • Certified Risk Adjustment Coding/Audit Specialist

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …Specialist analyzes and translates concurrent, prospective and retrospective medical and clinical diagnoses and procedures, injuries, and illnesses into Medical Risk ... Completes assignments with an emphasis on completeness, accuracy, and supporting clinical care plans to Risk Adjustment Data Validation (RADV) Timelines. Medicare… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Risk Score Accuracy (RSA) Program Manager…

    Bon Secours Mercy Health (Cincinnati, OH)
    … Coder (or equivalent), Licensed Practical Nurse or other clinical certification (preferred) **Education** Bachelor's Degree (preferred) **Work Experience** 5 ... effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Primary Function/General Purpose of Position** The… more
    Bon Secours Mercy Health (10/04/25)
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  • Inpatient Coding Quality Officer I - (All…

    RWJBarnabas Health (Oceanport, NJ)
    …critical thinking and a skill set above what is expected as a coder . Quality Officers must also sustain an excellent organizational average accuracy rate. Adherence ... ICD-10-CM/PCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required +… more
    RWJBarnabas Health (10/14/25)
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  • Coding Data Quality Auditor

    CVS Health (Helena, MT)
    …purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and ... confidently speak to such evidence across stakeholders with varying knowledge and clinical expertise in either written or verbal forms including communication with … more
    CVS Health (10/16/25)
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  • Senior Coding Educator

    Humana (Helena, MT)
    …and coding improvement opportunities and give guidance around operational and clinical best practices in the risk adjustment methodology. This role reports ... Risk Adjustment Manager and will work closely with market operations, finance, and clinical team to effectively influence a provider to adopt best practices in the… more
    Humana (10/14/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration requirements ... Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding configuration… more
    Commonwealth Care Alliance (08/26/25)
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  • Nurse Practitioner or Physician Assistant…

    CenterWell (Phoenix, AZ)
    …professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder , Referral Coordinator and more. Our approach allows us to provide an ... in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and...coding specificity. + Follows policy and protocol defined by Clinical Leadership. + Meets with RMD about quality of… more
    CenterWell (10/16/25)
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  • Nurse Practitioner / Physician Assistant

    CenterWell (North Augusta, SC)
    …professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder , Referral Coordinator and more. Our approach allows us to provide an ... in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and...coding specificity. . Follows policy and protocol defined by Clinical Leadership. . Meets with RMD about quality of… more
    CenterWell (10/16/25)
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  • Nurse Practitioner/Physician Assistant

    CenterWell (Atlanta, GA)
    …professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder , Referral Coordinator and more. Our approach allows us to provide an ... in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and...coding specificity. . Follows policy and protocol defined by Clinical Leadership. . Meets with RMD about quality of… more
    CenterWell (10/12/25)
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