- Excellus BlueCross BlueShield (Rochester, NY)
- …* Serves as a coordinator and key business resource for the Risk Adjustment Coding Coordination Team . * Conducts reviews and audits utilizing knowledge and ... ICD-9-CM/ICD-10-CM coding , Medicare Advantage and Commercial Hierarchical Condition Category ( HCC ) coding , and Medicaid Clinical Risk Groups (CRGs) to ensure… more
- Evolent (Phoenix, AZ)
- …+ Hires and oversees the initial orientation and development of Risk Adjustment coding team members, including coding support specialists. + Provides ... and updates. + Oversee and manage day-to-day risk adjustment coding team and operations, ensuring accurate and...supervisory role with strong leadership to manage, motivate and lead a team of coders to ensure… more
- East Boston Neighborhood Health Center (Revere, MA)
- …or regulatory updates. + Participate in professional development and maintain active coding certification(s). + Lead or assist with quality assurance reviews ... across multiple specialties + Extensive knowledge of cpt, revenue codes, ICD-10-CM coding and HCC /risk adjustment methodologies + Experience with Medicare… more
- CareFirst (Baltimore, MD)
- …expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:** Associate's ... work experience. **Experience:** 3 years risk adjustment/hierarchical condition category ( HCC ) coding experience. **Knowledge, Skills and Abilities (KSAs)**… more
- University of Virginia (Charlottesville, VA)
- …business objectives, process and organizational goals and workflow standardization + Serves as lead in fully integrating technical coding operations + Serves as ... the subject matter expert on Centers for Medicare and Medicaid Services (CMS) HCC documentation requirements and ICD-10-CM coding guidelines + Ensures key… more
- HCA Healthcare (Campbell, CA)
- …CMS RADV audits) Schedule and participate in provider training as needed. (Eg HCC software, documentation and coding guidelines) + Recommend projects to improve ... **_Note: Eligibility for benefits may vary by location._** Come join our team as a Managed Care Quality Improvement Specialist. We care for our… more
- Hartford HealthCare (Farmington, CT)
- …team , CDI and Revenue Cycle Leadership, physician leaders, all providers, quality management team , and coding team ongoing feedback. . Create relevant ... CDI Manager/Director. . Provides CDI subject matter expert guidance to CDS team , coding , physician leadership, quality management, utilization management, all… more
- Datavant (Augusta, ME)
- …between revenue, compliance, and user experience arise. **Leadership & Culture:** + Build, lead , and coach a team of Product Managers working across different ... healthcare technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models (eg, CMS- HCC , HHS- HCC… more
- Elevance Health (Grand Prairie, TX)
- …guidelines, provider coding audits, and participates in developing an investigation team that focuses on potential fraud, waste and abuse in the provider ... credential strongly preferred. + Experience with clinical documentation improvement and coding practices (ICD-10, HCC , MEAT criteria) strongly preferred. +… more
- Dignity Health (Phoenix, AZ)
- …security. **Job Requirements** **Minimum Qualifications:** - Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements. - ... Dignity Health. As a member of the Clinical Performance team , the Value Based Coder II works with providers...Qualifications:** - 2-3 years of experience in outpatient and/or HCC /risk adjustment coding preferred. - Certified Risk… more