• HCC Risk Adjustment

    UPMC (Pittsburgh, PA)
    …team members. Provides audit and coding related support to the internal Risk Adjustment Department. **Responsibilities:** + Utilize standard coding guidelines, ... the specified audit period or review time frame. + Participate in government Risk Adjustment Data Validation audits (RADV) conducting research of internal… more
    UPMC (05/21/25)
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  • HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    …that offers a flexible schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and ... regulations while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides...ICD-10 codes based on documentation, ensuring compliance with CMS risk adjustment and quality guidelines.… more
    MedKoder (04/15/25)
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  • HCC Risk Adjustment Coder PRN…

    Datavant (Columbus, OH)
    …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical...in a fast paced production environment while maintaining high quality . + Must be able to follow instructions, meet… more
    Datavant (03/27/25)
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  • HCC Coding Compliance Assistant

    Kelsey-Seybold Clinic (Pearland, TX)
    …or CPC (Certified Professional Coder) or CPC-A or CRC (Certified Risk Adjustment Coder) Preferred: N/A **Special Skills** Required: Analytical. ... **Responsibilities** To ensure the accurate coding of diagnoses which fall into the HCC model as required by CMS for Medicare Advantage plans. To ensure… more
    Kelsey-Seybold Clinic (04/23/25)
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  • Risk Adjustment Analyst- HIM OP CDI

    UNC Health Care (Chapel Hill, NC)
    …the health and well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for analyzing and auditing medical ... payer under the value care contracts. In addition, the Risk Adjustment Coordinator will be responsible for...the EPIC WQ to reorder the Hierarchical Condition Categories ( HCC ) conditions in the top 12 for claim generation.… more
    UNC Health Care (04/29/25)
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  • Manager of Quality - Risk

    HCA Healthcare (Campbell, CA)
    …and integrity. We care like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** ... Eligibility for benefits may vary by location._** Come join our team as a(an) Manager of Quality - Risk Adjustment Programs. We care for our community! Just… more
    HCA Healthcare (02/22/25)
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  • Risk Adjustment Coding Coordinator…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …and guidelines (eg ICD-9-CM, ICD-10, CPT, HCPC) * Familiarity and understanding of CMS HCC Risk Adjustment coding, Medicaid CRG coding, and data validation ... and coding policies to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the… more
    Excellus BlueCross BlueShield (05/20/25)
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  • Risk Adjustment Trainer

    Datavant (Trenton, NJ)
    …and life experiences to realize our bold vision for healthcare. We're looking for a Risk Adjustment Trainer to help us uplevel our Risk Adjustment ... HCC mapping and models + Experience with coding Medicare, Commercial and Medicaid risk adjustment charts + Understanding of Medicare, Commercial and Medicaid … more
    Datavant (05/07/25)
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  • Risk Adjustment Provider Education…

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …role will be responsible for representing Blue Cross Blue Shield MA's risk adjustment documentation and coding improvement initiatives through engagement with ... relationships with assigned providers / provider offices to improve risk adjustment coding and documentation accuracy and...conjunction with CRC preferred + Must pass pre-hire examination HCC /diagnosis coding + Must maintain 95% quality more
    Blue Cross Blue Shield of Massachusetts (05/10/25)
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  • Professional, Risk Adjustment

    MVP Health Care (Schenectady, NY)
    …of Hierarchical Condition Categories ( HCC )s and diagnosis codes related to Risk Adjustment programs to improve and optimize program targeting for Medicare ... Professional, Risk Adjustment Analyst Headquarters Office, 625...a passion for strategic engagement, data analytics, and healthcare quality improvement. **What's in it for you:** + Growth… more
    MVP Health Care (05/21/25)
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