- Trinity Health (Boise, ID)
- …Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing ... and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid… more
- Hartford HealthCare (Farmington, CT)
- …* Knowledge of ICD 10 Diagnostic and CPT coding regulations and guidelines and risk adjustment coding * Extensive knowledge of state, federal and ... & Kidney. Position Summary: The Director of Professional Services Coding will provide system wide leadership and strategic direction...Medicare regulations related to coding * Knowledge of the revenue cycle for the… more
- AdventHealth (Tampa, FL)
- …and approved coding policies and procedures. . Participates in the mortality/ risk adjustment reviews when assigned. . Assists with post-payment DRG appeals. ... a Primary Stroke Center. **The ro** **le you'll contribute:** The Inpatient Coding Quality Auditor, under general supervision of the Inpatient Operations Manager, is… more
- Humana (Providence, RI)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... more years of healthcare experience in revenue cycle management (related to billing, coding , collections for Medicare and Medicaid claims) + Experience with… more
- Hartford HealthCare (Hartford, CT)
- … Risk Adjustment Coder Educator develops and implements an enterprise-wide risk adjustment coding and documentation education program to support ... contracted providers that comply with CMS risk adjustment program requirements and ICD 10 coding ...settings 3. Identify process improvements to capture data for Medicare Risk Adjustment 4. Builds… more
- UPMC (Pittsburgh, PA)
- …Health Plan Network. + Coordinate and present education of providers/practices related to risk adjustment , coding , and clinical documentation improvement. + ... Plan. A general understanding of Health care insurance and Medicare managed care is highly preferred for this position,...reports to providers that summarize their performance related to coding and documentation and risk adjustment… more
- Insight Global (Tampa, FL)
- …. Skills and Requirements Active CPC or CCS 3-5 years of HCC/ Risk Adjustment coding experience Concurrent coding ... Medicare advantage projects . Must obtain an active Coding certification (CPC) through AAPC or AHIMA, or a...through AAPC or AHIMA, or a CCS. Will be coding more risk adjustment vs… more
- Hartford HealthCare (Farmington, CT)
- …documentation to disseminate audit requirements. 6. Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the ... documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding ...five years' work experience with CPT, HCPCS and ICD-10 coding conventions required. Experience with interpreting Medicare ,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …as the leader responsible for driving the Quality Performance Reporting & Analytics and Risk Adjustment for Medicaid Quality, Medicare Stars, and Exchange ... Oversee CAHPS and Stars analytics and improvement strategies for Medicare Advantage. + Ensure readiness for NCQA accreditation and...and supplemental data opportunities. + Deep knowledge of HCC Coding , risk adjustment models (CMS,… more
- Marshfield Clinic (Marshfield, WI)
- …stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the accuracy ... educational and training resource materials to assist providers in coding accuracy. The Educator develops and implements strategic action,...and integrity of risk adjustment data submitted to the Centers for … more