- Sutter Health (Sacramento, CA)
- …HS Diploma or General Education Diploma (GED) **CERTIFICATION & LICENSURE:** + CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or ... review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage,… more
- Hartford HealthCare (Farmington, CT)
- …collaboration with the Quality Management Department on mortality, PSI, HAC and other risk adjustment outcomes. . Shares accountability to present quarterly Key ... Revenue Cycle Medical Director to provide provider, CDI and coding education for DRG downgrade denials prevention and management....to understand and communicate the impact of CC/MCC's, PSI/HACs, risk adjustment , and other variables on the… more
- MedKoder (Mandeville, LA)
- … coding veteran, the company offers services including inpatient and outpatient facility coding , medical risk adjustment management, DRG coding ... disease processes, CPT coding and guidelines by the AMA, ICD-10-CM coding and guidelines, modifiers, surgical techniques, and Medicare (CMS/MAC) and Medicaid… more
- Stanford Health Care (Palo Alto, CA)
- …education, preferred. + Experience with Vizient, Premier, Elixhauser and other risk adjustment methodologies, highly preferred. **Required Knowledge, Skills and ... authoritative resource on interpretation and application of CDI practices, coding rules and regulations, and conducts risk ...Abilities** + Expertise in coding and CDI practices., maintaining expertise in Medicare… more
- MedKoder (Mandeville, LA)
- … coding veteran, the company offers services including inpatient and outpatient facility coding , medical risk adjustment management, DRG coding ... CPT coding and guidelines by the AMA, ICD-10-CM coding and guidelines, and Medicare and Medicaid billing policies for professional services. + Experience… more
- UNC Health Care (Smithfield, NC)
- …records to support appeal of denial. Works in conjunction with appropriate resources ( Coding , HIM or clinicians) to ensure that appeal is effective and is ... responsible for performing charge corrections / coding changes in accordance with all (internal and external) regulatory and coding guidelines/policies.… more
- Molina Healthcare (Columbus, OH)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job Qualifications** **Required… more
- Humana (Syracuse, NY)
- …and help us put health first** The Medical Records Retrieval Representative ( Risk Adjustment Representative 2) travels to provider offices within Upstate/Central ... a secure system. The records are reviewed by Humana's Coding staff. Territory includes the New York counties of:...Oneida, Onondaga, Oswego, St. Lawrence Medical Records Retrieval Representative ( Risk Adjustment Representative 2) + Travels up… more
- Banner Health (Phoenix, AZ)
- …This role leads enterprise strategies to improve cost efficiency, quality outcomes, risk adjustment accuracy, and contract performance across lines of business ... Professional (CPP); Chartered Property Casualty Underwriter (CPCU); Associate in Risk Management (ARM); CPA; SPHR; Registered Health Information Administrator… more