Senior Risk Adjustment & Coding Analyst (Remote)
Humana
Humana, Inc. is seeking a Senior Clinical Operations Professional to design and implement initiatives that optimize clinical operations and enhance care delivery across aligned area(s) or the organization.
The role involves identifying strategic improvement opportunities, establishing priorities, and developing standardized processes to support operational effectiveness. The position is remote with occasional travel to Humana offices for training or meetings, and requires a Bachelor’s degree
#J-18808-Ljbffr- ...Working remotely in a full-time capacity, the Senior Risk Adjustment Analyst will support Medicare Advantage and ACA Risk Adjustment programs by managing risk adjustment analytics and improving coding capture and revenue optimization. Key responsibilities Perform risk...Remote workSeniorRiskFull time
- ...Providing coding expertise for HCC initiatives, the full-time Senior Coding Analyst, Risk Adjustment will code medical records, support risk adjustment efforts, and collaborate... ...on clinical documentation improvement in a remote environment. Key responsibilities Review,...Remote workSeniorRiskFull time
$70k - $85k
...Astrana Health, headquartered in California, seeks a Risk Adjustment Coding Specialist II to support their Los Angeles area operations. The role focuses on reviewing chart data to identify coding gaps, educating providers, and tracking key KPIs, with up to 30% travel...SeniorRisk- ...Stanford Health Care seeks a Clinical Documentation Specialist-Risk Adjustment to lead risk adjustment coding activities in Palo Alto. The role focuses on CDI, prospective/concurrent reviews, and education across departments to ensure accurate HCC coding and regulatory...SeniorRisk
- ...Centene Corporation is seeking a Senior Actuary to join our fully remote Risk Adjustment team. You will conduct analysis, pricing, and risk assessments to estimate... ...FSA with 7+ or 5+ years respectively, strong SQL coding, SAS/Snowflake experience, and comfort translating...Remote workSeniorRisk
- ...Highmark Health is seeking a remote-based HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment coding. You will work with physicians and teams to ensure accurate ICD-10 and HCC disease capture, while adhering to CMS guidelines and RPM requirements. You...Remote workRisk
- Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support our Northern California market. The role involves extensive chart reviews, coding accuracy audits, and education for providers. Travel to provider offices is required up to 50-75% of...SeniorRisk
$100k - $115k
...Overview The Senior 340B Client Success Analyst supports covered entities... ...readiness. This is a remote, home-based position... ...accuracy, and recommend adjustments to improve program... ...VytlOne Business Code of Conduct, as well... ...complex or highest-risk Deployments (e.g., multi...Remote workSeniorRiskContract workTemporary workWork experience placementWork at officeWork from homeHome officeFlexible hours- ...Review medical records to validate reportable diagnoses and coding accuracy. Apply MEAT criteria and CMS guidelines for risk adjustment. Qualifications: CRC or related risk adjustment certification required. Minimum 2 years of HCC coding and risk adjustment experience....Remote workRisk
- ...Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider documentation and to tailor an education... ...You will report to the Manager, Coding Education and drive risk adjustment strategy across provider groups.The role requires CPC certification...Remote workSeniorRisk
$60k - $75k
...Bluestone Physician Services is seeking a detail‑oriented Certified Risk Adjustment Coding Specialist to conduct thorough patient chart reviews and... ...and CMS compliance while supporting providers across remote settings. The position offers full‑time hours, remote flexibility...Remote workRiskFull time- ...Humana Inc. is seeking a Senior Coding Educator to lead risk adjustment education for providers. You will design education plans, analyze provider documentation... ...presentations. Occasional travel to Humana offices may be required; remote work is supported.J-18808-Ljbffr...Remote workSeniorRisk
- ...Senior Analyst/Associate Revenue Cycle Management - Due Diligence... ..., identifies RCM risks and opportunities, and... ..., charges, payments, adjustments, denials, AR, payer,... ...authorization, charge capture, coding, billing, payment... ...a hybrid schedule. Remote option will be considered...Remote workSeniorRiskFull timeWork at officeLocal area
- ...Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider documentation and develop tailored education... ...sessions, webinars, and compliant presentations focused on risk adjustment and coding improvements. You will collaborate across teams,...Remote workSeniorRisk
- ...Humana Inc. is seeking a Senior Coding Educator to drive risk adjustment education for provider groups. You will design and deliver education plans, analyze data, and collaborate with the Quality and Cost Strategy team to improve documentation and coding processes....Remote workSeniorRisk
- ...Humana is seeking a Senior Coding Educator to lead risk adjustment education for providers across the network. You will design education plans, analyze documentation quality, and deliver sessions aimed at improving coding accuracy and compliant documentation. Reporting...Remote workSeniorRisk
$31.03 - $36.03 per hour
...2 years of relevant work experience is required in addition to the required work experience.3 years of risk adjustment and/or hierarchical condition category coding experience.Strong knowledge of diagnosis code validation, coding guidelines, and documentation standards...Remote workRiskTemporary workWork experience placement- ...Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider... ...CPC certification, 3+ years in risk adjustment education, data analysis, and strong PowerPoint... ...for training and meetings, with a remote work option and CST/EST hours.J-18808-...Remote workSeniorRisk
- ...Humana Inc. seeks a Senior Coding Educator to improve provider documentation and tailor an education plan for each assigned provider... .... You will report to the Manager, Coding Education and lead risk adjustment initiatives, data analysis, and targeted webinars. The role...Remote workSeniorRisk
- ...Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider documentation and to tailor education plans... ...report to the Manager, Coding Education.You will lead the risk adjustment strategy, analyze data for quality of care and coding...Remote workSeniorRisk
- ...Humana Inc. is seeking a Senior Coding Educator to identify opportunities to improve provider documentation and create tailored education... .... The role requires AAPC CPC certification, 3+ years in risk adjustment education, data analysis skills, and strong PowerPoint presentation...Remote workSeniorRisk
$58.7k - $70.4k
...Remote The Risk Adjustment Coding Analyst provides operational, analytical, and administrative support to business leaders and teams. You will analyze data to support decision-making, performance monitoring, project tracking, and partner communication. You will develop...Remote workRiskFull timeWork at officeWork from homeHome office- Highmark Health is seeking a skilled HCC Coder to support Medicare Advantage, ACA, and ESRD risk adjustment coding from a remote work setting. You will apply CMS guidelines to coding decisions and participate in RPM projects to ensure compliant documentation and accurate...Remote jobRisk
- Highmark Inc. is seeking a skilled HCC coder to support risk adjustment coding for Medicare Advantage and ACA programs. You will apply ICD-10, HCC models, and CMS guidelines across RPM and non-RPM projects, ensuring accuracy and compliance. Collaboration with physicians...Remote jobRisk
- ...Certified Risk Adjustment Coding SpecialistLocation: Trinity Health PACE Corp MichiganStatus: Full... ...HCCs.Position Details:This is a fully remote position. Work hours will be 8 to 4:30... ...Health PACE provides high-quality care to seniors in the communities we serve. Our...Remote workRiskDaily paidFull timeLocal areaHome office
$134.6k - $249k
...analysis, pricing, and risk assessment to estimate... ...while supporting the Risk Adjustment team through data... ...expertise with data analytics, coding, data validation, and... ...regular exposure to senior leadership and the opportunity... ...This position is fully remote, with Eastern and...Remote workSeniorRiskFull timePart timeWork at officeFlexible hours- ...Humana, Inc. is seeking a Senior Coding Educator to lead risk adjustment education for provider groups. You will analyze data, design education plans, and... ...role reports to the Manager, Coding Education and is remote with occasional travel to Humana offices. You will develop...Remote workSeniorRisk
$70k - $85k
...Risk Adjustment Coding Specialist II - Orange CountyWe are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will... ...fieldwork in Orange County (approximately 50% travel) with remote support to help practices. The Company reserves the right to...Remote workRiskWork at officeWork from homeHome office- ...coder to support Medicare Advantage and ACA risk adjustment initiatives. You will interpret clinical... ...and CMS guidelines to ensure accurate coding. Collaborate with physicians, Quality,... ...education, and process improvements. This remote role offers flexible scheduling and...Remote jobRiskFlexible hours
- An established industry player seeks a Risk Adjustment Audit and Compliance Specialist to enhance compliance and optimize risk adjustment... ...candidate will possess a strong background in risk adjustment coding, compliance, and auditing, along with a Bachelor's degree and...Remote workRiskFlexible hours
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