- Humana (Concord, NH)
- …provider. The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes data and ... educator and leader, tailor's provider group webinars and discussions based on various Risk Adjustment topics. **Use your skills to make an impact** **Required… more
- Elevance Health (Norfolk, VA)
- …hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables associates to ... project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates...equivalent and minimum of 3 years of experience as coder of medical records in physician office, hospital, or… more
- WMCHealth (Valhalla, NY)
- …Applicant link Job Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Specific duties ... setting with one or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder certification (CPC), Certified Professional… more
- Penn Medicine (Bala Cynwyd, PA)
- …+ Relevant coding medical professional services experience including ambulatory outpatient and risk adjustment coding (Required) + Additional experience could be ... accuracy of coding, compliance and clinical documentation. The Certified coder (CPC or CCS-P) is responsible for detailed analysis...in lieu of degree. + CCS or Certified Procedural Coder - CPC (AAPC) (Required) + **CRC (Preferred)** We… more
- 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 ... Hire Required:** + CCS-Certified Coding Specialist or + Certified Coder (CCS or CPC)-AHIMA or AAPC **Experience:** 3 years'...or CPC)-AHIMA or AAPC **Experience:** 3 years' experience in risk adjustment coding, ambulatory coding and/or CRC… more
- 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, ... Audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and… more
- 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 ... review, diagnosis coding, and/or auditing. + CPC (Certified Professional Coder ) or CCS-P (Certified Coding Specialist-Physician) required. **Preferred Qualifications**… more
- Henry Ford Health System (Detroit, MI)
- …to maximize accurate reimbursement. + Support initiatives for quality reporting, risk adjustment , provider education, and regulatory compliance. Innovation, ... of accountability, continuous learning, and professional growth; ensure ongoing coder education tied to compliance and regulatory changes. Compliance, Quality… more
- 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 ... in professional fee/physician services operations, analytics, and reporting. **Job:** **Business Office* **Organization:** **Scripps Health Corp* **Title:** *Senior Director, Revenue Cycle - Clinical Documentation Integrity* **Location:** *Central San Diego… more