- 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
- 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
- ChenMed (Miami, FL)
- …County laws and regulations related to coding and documentation guidelines for Risk Adjustment Reviews of medical records , patient medical history ... their office staff and other support departments to review medical records and other clinical documentation to...records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure… more
- 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
- The Cigna Group (Bloomfield, CT)
- … Adjustment Data Validation audits (RADV), Risk Adjustment operations, Risk Adjustment medical record and diagnosis coding excellence, ... Clinic, and CMS guidelines for IFP code abstraction and medical record compliance + Demonstrates comprehensive understanding...and have excellent organization skills + Risk Adjustment /CMS knowledge helpful + Understanding of medical … more
- 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
- 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 (Bloomfield, CT)
- …in ICD-10-CM medical diagnosis coding * Familiarity with CMS regulations for Risk Adjustment programs helpful. * Medical claims, billing, or inpatient ... code accuracy and compliance in support of the HHS' Risk Adjustment (RA) program and Risk...Protocols *Audits accuracy of abstracted diagnostic codes from identified medical record cohorts, evaluating work of peers… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …right for you, we encourage you to apply! Job Description: Summary The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making ... completeness in diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation...the following programs, including but not limited to prospective medical record review of health plan providers,… more
- 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