ICD Coding Quality Auditor - Risk Adjustment Expert
Internationalinsuranceprofessionals
CVS Health is seeking a detail‑oriented reviewer to perform quality audits of medical records coded for CMS risk adjustment. You will support ICD coding accuracy, mentor staff, and lead dispute resolution across teams to ensure regulatory compliance. The role emphasizes independent work and cross‑functional collaboration with policy and clinical staff, focusing on improving documentation quality and audit outcomes within a full‑time schedule. #J-18808-Ljbffr Internationalinsuranceprofessionals
$70k - $85k
Risk Adjustment Coding Specialist II - Los Angeles Department: Strategy and Operations Employment Type: Full Time Location... ...(HCC) Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported...RiskFull timeWork at office- ...seeking an Outpatient Coder I to accurately abstract data following ICD-10-CM, CPT, HCPCS guidelines across the HMN network. This role... ...with physicians for clarification.The position emphasizes coding accuracy, timely productivity, and adherence to CMS directives,...Suggested
- Umcelpaso seeks a Certified Medical Coder to accurately code, sequence, and abstract outpatient records per ICD-10-CM and CPT guidelines, ensuring timely reimbursement and data integrity. You will query physicians for documentation clarification and work within approved...Suggested
- ...% of the work involves hands-on coding and configuration. The technical... ...resilience patterns. The Expert FDE is expected to lead complex... ...observability, and operational risks. - Write, debug, review, and enhance production-quality code and configuration...RiskFull timeContract work
$100k - $140k
...TypeFull Time Key responsibilitiesAre you a sharp evaluator of risk? Can you investigate complex situations and propose solutions?... ...disability inclusion and if you need reasonable accommodation/adjustments throughout our recruitment process, you can always contact us.Contact...RiskFull timeFlexible hours$19.5 per hour
...a career. The role of a Human Resources Expert can provide you with the skills and experience... ...a positive and respectful attitude ~ Adjust to business and guest needs to deliver an... ...compliance policies that mitigate risk to the team member experience. ~ Demonstrate...RiskHourly payWork at officeLocal areaFlexible hoursShift workNight shiftDay shift- Centene Corp. in Asheville, NC, is seeking a Quality Practice Advisor to build strong... ...practices and IPAs while advancing HEDIS and risk adjustment initiatives. This role requires... ...measures, medical record documentation, and coding practices. The ideal candidate will...RiskRemote job
- ...is seeking an Outpatient Coder I to accurately abstract data per ICD-10-CM, CPT, and HCPCS guidelines across the HMH network. You'll... ...Qualified candidates hold at least a GED, have 1 year of outpatient coding experience, and possess strong medical terminology and...
$120k - $150k
...insights to drive continuous improvement Act as central subject matter expert and key interface between ISC Product, Solution Design,... ...Development and Solution Design teams for opportunity qualification and risk assessment Identify gaps between platform capability and...RiskPermanent employmentLocal area- ...valuation control platforms.Develop and enhance pricing, risk, IPV, valuation adjustment, and fair value reporting tools within Athena.Design,... ...modernization initiatives.Establish engineering best practices, code quality standards, CI/CD processes, testing frameworks, and...Risk
- ...Role Details Job Title: Property Claims Adjuster Location: Remote / Hybrid (dependent upon... ...Help us insure it Tokio Marine HCC - Public Risk Group, a member of the Tokio Marine group... ..., appraisers, vendors, and technical experts for on-site investigations and damage assessments...RiskFull timeWork at officeLocal areaRemote work
$20.5 - $27.85 per hour
...Remote - Florida Department: Coding Work Type: Full Time Shift: Shift... ...medical records according to ICD-10-CM and CPT-4 guidelines,... ...Diagnostic, Documentation Quality Assurance, and Ancillary records... ...Coder-Payer) CRC (Certified Risk Adjustment Coder) CIC (Certified...RiskFull timeRemote workShift work- Commence is seeking a Remote Medical Coding Reviewer to perform coding-focused reviews of Medicare Part A/B and DMEPOS claims. You will verify ICD-10-CM, CPT, and HCPCS codes, ensure medical necessity, and document findings in the case-tracking system. Qualified candidates...Remote job
- ...and businesses to make better decisions on risk, faster.At Verisk, you'll have the chance... ...development life cycle, including coding standards, code reviews, source control management... ...automated tests to ensure application quality.• Test and validate AI-driven solutions,...Risk
- ...of crop insurance and other agricultural risk management tools, we recognize that our success... ...unique opportunity for a Crop Insurance Adjuster to join our Southeast team, supporting... .... This is why we offer competitive, high-quality compensation and benefit programs to...RiskFull timeWork at officeRemote workWorldwideHome officeFlexible hoursWeekend work
- ...bridge engineering, architecture, risk, compliance, security, and... ...of the rapidly evolving GenAI coding ecosystem, and the leadership... ...as the senior subject matter expert on the evolving landscape of GenAI... ...to balance innovation, speed, quality, and control in enterprise...RiskFull timeWork at officeLocal areaRemote work1 day per week
- ...supervision of the Director of Pharmacy Services, the pharmacist will manage antimicrobial therapy and participate in critical care and high-risk patient care within the pharmacy department. The role involves collaboration with health professionals, education responsibilities,...Risk
- ...Expertise to JPMorgan Chase. As part of Risk Management and Compliance, you are at the... ...anticipating new and emerging risks, and using your expert judgement to solve real-world challenges... ...governance subject matter expertUse coding agents to build prototypes and...Risk
$76.86k - $102.62k
...considered the technical expert in planning and... ...control, forecasting, risk management, change management... ...structures, calendars, coding, responsibility assignments... ..., maintenance, quality assurance, and integrity... ...Light work that includes adjusting and/or moving objects up...RiskContract workFor subcontractor$5,000 per month
...business days to reduce financial risk. Conduct follow-ups with... ...issues. Compliance and Quality Assurance: Ensure all... ...necessary, making the appropriate adjustment Responsible for refiling... ...experience utilizing CPT, ICD-10 and modifier coding preferred High school...RiskPrivate practiceWork at officeImmediate start$61k - $101k
...Experience with Python design and coding, Flask, Django, or comparable... ...Develop secure, high-quality production code, and review and... ...function-wide subject matter expert in one or more areas Contribute... ...including Finance, Treasury, Risk Management, Human Resources, Compliance...RiskFull timeFor contractorsWork at office- ...catastrophe-exposed property insurance, is seeking a Senior Catastrophe Risk Analyst. In this role, you’ll play a critical part in advancing... ...catastrophe modeling platforms (RMS, Verisk, AIR, etc.). Strong coding and data analysis skills (e.g., Python, R, SQL). Experience...RiskLive in
$61k - $101k
...Experience developing, debugging, and maintaining code in a large corporate environment using one... ...AI coding tools to improve code quality, delivery speed, and productivity while validating... ...Global Finance, Corporate Treasury, Risk Management, Human Resources, Compliance, Legal...RiskFull timeWork at office- ...businesses to make better decisions on risk, faster.At Verisk, you'll have... ..., possessing leadership qualities, able to work independently... ...articles to meet customer needs.Coding logic and program... ...business units and subject matter experts (actuarial, datal and technology...RiskWork at office
- ...in the market by optimizing various aspects of the investment, risk management, portfolio construction, and trade execution lifecycle... ...field) ~2-6 years professional experience. Finance industry experience preferred. ~ Strong coding skills required; Python preferred...Risk
$63.79k - $79.75k
...are committed to providing high-quality care to our diverse patient... ...the direction of the facility Coding and Reimbursement Manager, conducts... ...on regulations and providing expert guidance to coders. Provides... ...for Coding and reporting for ICD-10-CM/PCS, CPT-4, and HCPCS coding...Remote workMonday to FridayShift work$112k
...receive mandated in-servicing in Safety, Quality Assurance, Risk Management, Customer Service,... ...* General and procedural consents, Coding issues (CPT, ICD) to ensure maximum reimbursement, Compliances... ...system template manager, making adjustments to the patient scheduling system...RiskWork at officeMonday to FridayWeekend work- AriensCo in Fayetteville, TN is hiring a Quality Technician to support manufacturing by inspecting, auditing, testing, and ensuring conformance... ...and engineering to improve process capability and reduce risk. Responsibilities include daily process and product audits, problem...Risk
- ...organization, apply now.We are currently seeking a Senior SQL Developer (Expert Level / FTE / Onsite) to join our team in Jersey City, New... ...operations in production environments.Establish and enforce SQL coding standards, naming conventions, and best practices across the...Work at officeRemote workFlexible hours
$159 - $193 per hour
...Corporate Functions & Non-Financial Risk Data GovernanceThe Data Office... ...journey to enhance the quality, control, and accessibility of... ...as a business subject matter expert while partnering with stakeholders... ...reporting development role.No coding, statistical modeling, or...RiskFull timeWork at officeLocal areaRemote work1 day per week
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