• Risk Adjustment Coding

    CareOregon (Portland, OR)
    Job Title Risk Adjustment Coding Manager...management of the risk adjustment coding and provider education programs for the Medicare ... must reside in Oregon or Washington. Job Summary The Risk Adjustment Coding Manager is...materials. + Maintain an expert level of knowledge of Medicare and HCC risk -based reimbursement methodologies, policies… more
    CareOregon (04/10/25)
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  • Risk Adjustment Coding

    Excellus BlueCross BlueShield (Buffalo, NY)
    …see is right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of ... diagnosis coding . This position is responsible for risk adjustment coding and quality...Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding , and Medicaid Clinical Risk Groups (CRGs)… more
    Excellus BlueCross BlueShield (05/05/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    … Advantage Risk Adjustment , you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, ... Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Reliable...understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems required + Knowledge of Medicare more
    UCLA Health (02/19/25)
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  • VP Risk Adjustment Accuracy…

    Highmark Health (Pittsburgh, PA)
    …At least five years' direct management experience Preferred: + 5 or more years' Medicare and/or Commercial risk adjustment experience + Previous involvement ... programs to ensure comprehensive and accurate diagnosis coding for risk adjusted government programs ( Medicare Advantage, ACA business, and Medicaid).… more
    Highmark Health (04/30/25)
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  • Risk Adjustment Trainer

    Datavant (Trenton, NJ)
    …and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... Medicare , Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding of health insurance plans operations + Deep… more
    Datavant (05/07/25)
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  • Director for Quality and Risk

    Robert Half Accountemps (Long Beach, CA)
    …for leading enterprise development of the Medicare Star Ratings and Enterprise Risk Adjustment strategies that ensure our risk adjusted and Star ... assurance, coding , submissions, and audit services for risk adjustment revenue optimization. . Develop roadmap...military experience will be considered. . Strong knowledge of Medicare Star Ratings and risk adjustment more
    Robert Half Accountemps (04/04/25)
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  • Risk Adjustment Analyst

    CareOregon (Portland, OR)
    …and prepares various production and ad hoc reports aligned with risk adjustment initiatives and strategies for both the Medicare and Medicaid lines of ... Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Risk Adjustment Analyst Department Finance Exemption Status...and reliability. + Calculate risk scores and risk score related reporting for both the Medicare more
    CareOregon (05/03/25)
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  • Risk Adjustment Representative

    Humana (Little Rock, AR)
    …for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 3 ensures coding is accurate and properly ... caring community and help us put health first** The Risk Adjustment Representative 3 conducts quality assurance...as well as internal policies and guidelines while analyzing coding information and medical records. May participate in provider… more
    Humana (05/07/25)
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  • IPA Coding Associate Director

    CenterWell (Des Moines, IA)
    …clinical documentation. + Partner with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, ... provider coding improvement opportunities, risk score trending and tracking. + Partners with MRA...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions.… more
    CenterWell (04/24/25)
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  • Coding Auditor

    CareOregon (Portland, OR)
    …Exemption Status Exempt Management Level n/a Direct Reports n/a Manager Title Director Risk Adjustment Department Finance Pay and Benefits Estimated hiring range ... reside in Oregon or SW Washington. Job Summary The Coding Auditor performs code audits and is responsible for...or AAPC + For Finance Department only: Current Certified Risk Adjustment Coder (CRC) or completion within… more
    CareOregon (03/11/25)
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