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We're looking for a Coding Specialist II- Risk Adjustment Coder to join our team! Preferred: Certified Risk Adjustment Coder (CRC). Preferred: Minimum of 3+ years of diagnosis coding experience Risk adjustment coding experience Knowledge of CPT and E&M Strong ICD-10 knowledge.
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Performs review of Risk Adjustment audits for accuracy and for data entry into the EMR.Utilizes nursing and coding knowledge to assist with review activities to support the Risk Adjustment process to include re-review of audit findings to ensure accuracy in documented HCC diagnoses and ICD-10 coding; review of various payer denial/rejection reports to identify areas for provider education.
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Certified Risk Adjustment Coder (CRC) from AAPC is required. 2 years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding) required. Risk Adjustment Education Specialist - Health Plan Admin.
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Ashu Sr. Medical Coder / Risk Adjustment Coder | Remote | Contract. Our direct end-client a large healthcare insurance provider is seeking to hire a Senior Professional Coder/ Risk Adjustment Coder for a 6+ months contract role to work 100% remote | W2 only.
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Certified Risk Adjustment Coder (CRC) required; Certified Clinical Documentation Specialist (CCDS) preferred. Expertise in CMS Risk Adjustment Data Validation (RADV) for Medicare Advantage Plans, and medical coding, including but not limited to E/M, ICD-10, CPT, and HCC coding preferred.
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Experience:Prior HCC/HHS experience with Medicare Risk Adjustment with three (3) years’ experience in medical coding. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”The Capital BlueCross Government Programs Risk Adjustment coding position is a unique position that combines knowledge and experience in risk adjustment coding, Medicare and Government regulations, Medicare Advantage risk adjustment model, HHS ACA risk adjustment models, and RADV and HRADV experience.
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Skills Required: Requires experience in the following: Risk drivers for Capital Markets and Alternative Investments; Global project planning; gap analysis; UAT scripts; quantitative margin methodologies for marketable securities; independent statistical inference, problem solving for credit risk, and economic scenario development; delivering solutions within a matrix organization; Python; SQL; R; Tableau; Shiny; Jupyter; and LaTex.
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Experience: IT/IT Security and/or Corporate Risk/Audit Work experience- 6+ years IT Risk Management and/or IT Internal Audit including experience in Information Security & Technical Privacy- 4+ years.
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The Enterprise Risk Analyst is expected to leverage their subject matter expertise in ERM when acting as business partner with our colleagues in the first line of responsibility when performing their daily Risk & Control Activities (RCA) in accordance with company policy and procedures.
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Required Certification: Active certified coder certification through AHIMA or AAPC required: CRC, CPC, CCS-P, CCS (Certified Risk Adjustment Coder, Certified Professional Coder, Certified Coding Specialist- Physician Based.
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Willing to work toward certifications such as CIA, CAMS, CRMA, or others that apply to regulatory compliance and/or risk management. Support the Third-Party Risk Management Manager by performing second line monitoring related to third parties.
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Certified Professional in Health Care Risk Management (CPHRM) certification is preferred. Your role collects, evaluates, and distributes relevant data concerning patient injuries: aggregate data summaries, monthly trend analyses of incidents, claims profiles, and workers’ compensation trends; provides aggregate analysis of risk data; maintains statistical trending of losses and other risk management data.
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The IT Risk Analyst would maintain information that will allow the Information Security Officer to keep executive management informed about the results of the risk assessments and make recommendations for mitigation.
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License/Certification Certified Professional in Healthcare Risk Management (CPHRM), preferred. The Manager of Risk Management is a key member of the leadership team and will be responsible for assisting the Director of Risk Management in leading our hospital's Patient Safety-Risk Management Program.
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This position is responsible for assisting with the development and implementation of the risk and safety management program for WSI Supply Chain. The Risk and Safety Coordinator position is located in Olive Branch, MS.
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Title: risk adjustment Company: Excellus Blue Cross Blue Shield
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