- CenterWell (Tallahassee, FL)
- …interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... Responsible for performance management and strategy development for PCO risk adjustment at the division and market...Leader to identify and influence enhancements to the GenAI ( CODER ) tool to improve the medical coder … more
- Highmark Health (Cheyenne, WY)
- …anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with ... leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient...CERTIFICATIONS** **Required** (any of the following) + Certified Professional Coder (CPC) + Certified Risk Coder… more
- 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