- Catholic Health Initiatives (Little Rock, AR)
- …may be involved. + Supports quality, clinical practice, safety, risk coding , compliance, patient experience and Health Information Management functions within the ... + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. +...the Risk Auditor Manager of closely working with the HCC Risk auditors to establish, and update daily workflows… more
- Insight Global (Plano, TX)
- …Condition Category ( HCC ) capture, Case Mix Index (CMI), and other coding factors. Apply current clinical criteria including MCG, InterQual, payer clinical policy ... Group (DRG) validation and quality audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote opportunity and the… more
- J&J Family of Companies (San Bernardino, CA)
- …authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, ... regional, local, and account market dynamics including coverage and coding requirements. + Grow the knowledge of hub and...departments such as marketing, sales, medical science, SCG, IBG, HCC , and PECS. Serve as subject matter expert regarding… more
- CareFirst (Baltimore, MD)
- …CMS guidelines, monitoring and determining the impact of any changes to the HCC model and supporting actuarial in the calculation risk adjustment revenue. + Assists ... goals are met and propose opportunities in accurate reimbursement based on the HHS- HCC (Hierarchical Condition Code) model. Perform data mining of claims and data to… more
- MVP Health Care (Schenectady, NY)
- …opportunities and obstacles. + Measure capture rate of Hierarchical Condition Categories ( HCC )s and diagnosis codes related to Risk Adjustment programs to improve ... + Use Clinical Risk Group (CRG) software to target interventions for improved coding for Medicaid members. Calculates ROIs for Risk Adjustment programs. + Maintain… more
- Aston Carter (Columbia, MD)
- …and completeness. Process employee reimbursements by verifying approvals, account coding , and compliance with college policies. Manage the Accounts Payable ... programs. As a participating member of the Maryland Retirement and Pension System, HCC offers two retirement options: The Pension, which requires a 7% employee… more