• Risk Adjustment Medical

    BlueCross BlueShield of Tennessee (Nashville, TN)
    The Risk Adjustment Medical Record Retrieval team at BCBST is seeing a Medical Record Retrieval Specialist to join our team\. In this role, you ... records \. Preferred candidates will have experience with medical records and Electronic Medical Record system\(s\)\. You will be a great match for… more
    BlueCross BlueShield of Tennessee (11/12/25)
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  • Risk Adjustment Medical

    Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
    …required **Work Experience** + Minimum of 2 years of experience in reviewing / retrieving records for Risk Adjustment , and HEDIS projects required + CMS and ... tags medical records into document management system. + Perform onsite medical record review and abstract needed information to be uploaded into BCBSLA… more
    Blue Cross and Blue Shield of Louisiana (11/12/25)
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  • Certified Medical Coder ( Risk

    Apex Health Solutions (Houston, TX)
    …Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding ... and compliance with Risk Adjustment requirements. EDUCATION: . High School...complete understanding of their real-world application . Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring… more
    Apex Health Solutions (09/26/25)
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  • Auditor, HCC Risk Adjustment Coding…

    Datavant (Indianapolis, IN)
    …As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate ... representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into… more
    Datavant (11/07/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …is responsible for day-to-day oversight of a team of Coding Analysts specializing in HHS Risk Adjustment medical record diagnostic coding and quality ... Responsibilities:** + Leads team of certified coding professionals to accurately perform Risk Adjustment medical record reviews and audits, assigning… more
    The Cigna Group (11/06/25)
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  • Health Care Disputes - Compliance Risk

    Ankura (New York, NY)
    …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice ... Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects...with RADV Audit responses including managing the collection of medical records , overseeing the selection of … more
    Ankura (09/09/25)
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  • Risk Adjustment Coding Specialist…

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... (RADV) audit and any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all applicable… more
    CareFirst (09/26/25)
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  • Risk Adjustment QA Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career ... join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at...CMS RADV audits, including retrieval and coding of targeted medical records . * Design and implement QA… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Director of Risk Adjustment

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location: Hybrid | Eagan, Minnesota Career Area: Special ... Lines The Impact You Will Have The Director of Risk Adjustment is a key leader responsible...opportunities, and evaluation of in-home assessments, in office assessments, medical record retrieval and coding reviews, and… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Senior Risk Adjustment Coding…

    Centene Corporation (Jefferson City, MO)
    …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... oversight. Reviews medical records...complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical… more
    Centene Corporation (10/29/25)
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