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HCC Risk Adjustment Coders will be involved with activities of code abstraction for the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation.
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Bonus PointsCertified Risk Adjustment Coder (CRC) or similar certificationExperience coding in multiple different Electronic Medical Record (EMR) systems. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment team.
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Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist , P from the American Health Information Management (AHIMA.
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These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company.
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This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.
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Must hold a Certified Risk Adjustment Coder (CRC) and Certified Professional Coder (CPC) certification. The CDI Specialist supports clinical documentation to ensure complete, accurate, and compliant coding for Medicare and Medicare Advantage beneficiaries.
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This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction.
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Abstract data from records to evaluate (a) conformance to billing documentation standards and (b) utilization of services in programs that bill Medicaid, Medicare or other third party billing for reimbursement of such services, and develop written reports of findings and recommendations for executive and program managers and Board of Directors' Committees as directed.
$65,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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About NYC Health Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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Position Overview The Inpatient/Outpatient Coder is responsible for conducting coding audits and education for providers with greatest opportunity for improvement. MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
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Business Professional - Professional Coder I. Business Professional - Professional Coder I. Requires 2 5 years of Medical Coding experience. Requires a minimum of 2 years’ experience in Health Insurance/quality chart audits and/or Utilization Review.
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Support educational activities for internal stakeholders as necessary as subject matter expert on coding review/guidelines. Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations.
$38 - $39.56 an hourExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.
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For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
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