• Risk Adjustment Clinical…

    UPMC (Pittsburgh, PA)
    UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor/Analyst position in the Medicare department. This is a full time position ... The Clinical Auditor/Analyst is an integral part of the Risk Adjustment Department and is responsible for...are supported within the audit year, and utilize AHA Coding clinics, ICD-10-CM Coding Guidelines, CPT … more
    UPMC (09/30/25)
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  • Risk Adjustment Analyst

    Fallon Health (Worcester, MA)
    …or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Risk Adjustment Analyst (RAA) will be a SME for the MassHealth ... risk adjustment model(s) and related data submission...and will develop reporting to enhance efficiency of Fallon's chart retrieval process. The RAA will support development and… more
    Fallon Health (09/06/25)
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  • HCC Risk Adjustment Coder - Full…

    Datavant (Washington, DC)
    …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... guidelines. + Coders must meet and maintain a 95% coding accuracy rate. + Any other task requested by...plus the option to earn up to $3.25 per chart based on quality and production.** We are committed… more
    Datavant (08/26/25)
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  • Medicare Risk Adjustment

    TEKsystems (Sunrise, FL)
    …Experience with preserved medical record retrieval systems preferred. Billing or coding experience preferred. Excel skills. Responsibilities: - Retrieves charts from ... compile medical records to send to other parties for coding . - Requests medical records by making outbound phone...by updating member and provider demographics and working with chart load issues. - Ensure follow up on member… more
    TEKsystems (09/23/25)
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  • Medicare Risk Adjustment

    TEKsystems (Sunrise, FL)
    …Retrieve charts from electronic medical record systems and compile medical records for coding purposes. + Make outbound phone calls to provider groups to request ... vendor pends promptly by updating member and provider demographics and addressing chart load issues. + Ensure follow-up on member appointments or other designated… more
    TEKsystems (09/20/25)
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  • Consultative Coding Professional

    CenterWell (Tallahassee, FL)
    …make an impact** **Required Qualifications** + A minimum of three years of technical Medical Coding , focused on outpatient ( risk adjustment ) coding . + ... manipulates database. Responds to or clarifies internal requests for coding and/or documentation related information. Understands department, segment, and… more
    CenterWell (09/25/25)
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  • Coding Auditor & Educator

    WelbeHealth (Charleston, WV)
    …and experience in coding and auditing + Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a managed care environment + Current ... Care for the Elderly) Dual participants + Conduct pre-visit chart preparations and post-visit chart reviews +...in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines + Work… more
    WelbeHealth (09/19/25)
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  • Coder (medical coding )

    Geisinger (Danville, PA)
    …One of the following certifications is needed at time of hire: Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC) Registered ... Job Summary Health information coding is the transformation of verbal descriptions of...Technician (RHIT) - American Health Information Management Association; Certified Risk Adjustment Coder - American Academy of… more
    Geisinger (09/30/25)
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  • Physician Educator HPL- Remote- Allegheny County

    UPMC (Pittsburgh, PA)
    …Health Plan Network. + Coordinate and present education of providers/practices related to risk adjustment , coding , and clinical documentation improvement. + ... and documentation guidelines. + Analyze medical record documentation and coding through a chart review process that...reports to providers that summarize their performance related to coding and documentation and risk adjustment… more
    UPMC (09/26/25)
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  • Clinical Data Abstraction Specialist

    Apex Health Solutions (Houston, TX)
    …Records (EHR) Experience * Minimum of three (3) years HCC experience performing retrospective risk adjustment chart review required. * Minimum of three (3) ... inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment...accurately records all appropriate records and data on assigned chart abstraction projects. * Ability to meet productivity and… more
    Apex Health Solutions (09/26/25)
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