- UnitedHealth Group (Brooklyn, NY)
- …providers in understanding the Medicare quality program as well as CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance ... programs focused on improving the quality of care for Medicare Advantage Members. Will be out in the field...coding Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the… more
- Optum NV (Las Vegas, NV)
- …They will support the market oversight and direction of Outpatient Care Management Services, Medicare Risk Adjustment Factor (RAF) education as well as ... Medicare Advantage programs (STARS, RAF, HEDIS, CHAPS/HOS etc.) Experience with Medicare risk adjustment and presenting findings to client/providers… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics....to ensure complete and accurate medical record documentation and coding . The Program Manager will contribute to the development… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works...and MEAT (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare… more
- 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 (Los Angeles, CA)
- …and others. + Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: ... Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful… more
- Blue KC (Kansas City, MO)
- …documentation and quality coding . + Provide Government Programs oversight to ensure Medicare Advantage and ACA Risk Adjustment and state regulations are ... state and federal regulatory guidance for risk adjustment , audit and documentation and coding accuracy...+ Maintain expert knowledge of ACA risk adjustment regulations + Maintain expert knowledge of Medicare… more
- Trinity Health (Syracuse, NY)
- …compliance standards in our provider group. **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** Risk adjustment coding , provider auditing and clinical/education ... specialist with a solid background in value-based plans (VBP), Medicare Advantage (MA) and Medicare shared savings...and REQUIRED CERTIFICATION, EDUCATION, LICENSURE AND EXPERIENCE INCLUDES:** + Risk Adjustment Coding - Certified… more
- Tufts Medicine (Burlington, MA)
- …Provides education and feedback to physicians on a regular basis in regard to Risk Adjustment Coding guidelines (HCC/DxCG), as well as ICD-10-CM Guidelines ... meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ICD-10-CM … more
- Corewell Health (Grand Rapids, MI)
- …This position will evaluate and assess the organization's risk related to risk adjustment coding and conduct internal audits to improve compliance. ... risk adjustment exposure/ risk . Contributes to and approves Priority Health Risk Adjustment Coding Guidelines. + Serve as point person for… more
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