Risk Adjustment Coding & QA Specialist
Centrumhealth
NeueHealth is seeking a Coding Coordinator to ensure accurate coding and compliance across risk adjustment and Medicare Advantage programs. The role focuses on primary coding contacts for compliance oversight, accuracy, and opportunities for improvement. Responsibilities include audits, medical records retrieval, and ensuring documentation supports ICD-10-CM codes while maintaining certifications. Strong written and verbal communication is essential. #J-18808-Ljbffr Centrumhealth
- Baptist Health is seeking a Certified Professional Coder to perform medical record reviews and coding to support risk adjustment and Medicare compliance. The role involves identifying documentation gaps, communicating with providers, and ensuring accurate ICD-10-CM coding...Risk
- Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role requires conducting quality audits specific to ICD-10 code abstraction and ensuring compliance with coding standards. The ideal candidate holds a Bachelor's degree...RiskRemote job
- Mount Sinai Medical Center of Florida, Inc. is seeking a Certified Risk Adjustment Coder to ensure accurate coding and documentation standards. The role involves reviewing medical records, providing feedback to physicians, and maintaining coding credentials. The ideal candidate...Risk
$143.62k - $229.79k
...Job Description As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical... ...- Highly Preferred Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their impact...Risk- Cano Health, LLC is seeking a Risk Adjustment Coder to join our hybrid team in New York. The coder will identify and document coding information crucial for Clinical Condition Categories and ensure diagnosis code accuracy. This role involves regular collaboration with...Risk
- Centene Corporation is seeking a Senior Risk Adjustment Auditor to support CMS payments and quality of care across our provider network in... ...with risk adjustment guidelines while maintaining policy standards and high accuracy in coding. #J-18808-Ljbffr Centene CorporationRiskRemote job
$56.2k - $101k
...medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve... ...ICD-10 coding) for WellCare’s Medical Coding Specialists. Communicates QA results to the Medical Coding Specialists...RiskFull timePart timeWork at officeRemote workFlexible hours- ## Certified Risk Adjustment CoderApplylocations: Hialeah, FLtime type: Full timeposted on: Posted Todayjob requisition id: JR102682**As Mount... ...:**## Position Responsibilities* Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment...RiskWork at office
- ## Risk Adjustment CoderApplyremote type: Hybridlocations: Jupiter, FLtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR... ..., collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories....RiskWork at officeFlexible hoursWeekend work
- ...United States is seeking a Senior Actuarial Analyst to support Risk Adjustment Actuarial Services. You will assist in financial analysis,... ...reporting. The role partners with clinical, operational and coding teams to improve documentation accuracy and establish equitable...RiskRemote job
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- ...company expertise. Our Crop Division has been helping farmers manage risk since 1915 and is one of the few private companies authorized by... ...part‑time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for all major crops,...RiskFull timePart timeSeasonal work
- Nebraska Blue Cross and Blue Shield is seeking a Risk Adjustment Health Data Analyst to join our Healthcare Analytics team. You will analyze claims, enrollment, and risk adjustment submissions to evaluate program performance and identify opportunities for improvement. The...RiskRemote job
$23.21 - $29.48 per hour
...identified visits to determine appropriate ICD-10-CM coding and billing and compliance with Medicare Risk Adjustment metrics. Supports continuum of patient care by... ...completion of an accredited certified coding specialist program. 2 + years of clinic or hospital experience...RiskRemote job$70k
...maintenance, financial, administration & risk management. As an on-site leader, you will... ...trends and recommend strategies and adjustments Develop yearly operating budgets/forecasts... ...the timely receipt, reconciliation, and coding of all vendor invoices Ensure property closeout...RiskPermanent employmentFull timeFor contractorsWork at office- ## Risk Adjustment Health Data AnalystApplyremote type: Hybridlocations: Remote flexibility for candidates in FL, IA, KS, MN, MO, NE, ND, or TXtime type: Full timeposted on: Posted 3 Days Agojob requisition id: JR101331At Blue Cross and Blue Shield of Nebraska, we are a...RiskLive inRemote work
- ...external providers to drive performance reporting and interventions for accurate diagnosis capture and reporting. The ideal candidate has 7+ years in consulting or program management with Risk Adjustment experience and strong relationship skills. #J-18808-Ljbffr CVS HealthRisk
- AdventHealth is seeking a Clinical Documentation Specialist to review ambulatory documentation, improve coding accuracy, and ensure compliant ICD-10 coding... ...record review, regulatory knowledge, and experience with Medicare risk adjustment. #J-18808-Ljbffr AdventHealthRisk
- CenterWell Senior Primary Care seeks a Manager, IPA Consultative Medical Coding to lead a regional team focused on risk adjustment accuracy and documentation excellence. You will guide the transition to a longitudinal consultative model, align operations with market needs...Risk
- ...Job Title: Quality Assurance Specialist – Sterile Manufacturing Location: FL (Onsite) Duration... ...operations. Responsibilities Provide QA oversight for aseptic vial filling, stoppering... ...audits, inspections, and quality risk assessments. Partner with Manufacturing and...Risk
- ...mind to patients nationally. Job Summary: The Quality Assurance (QA) Specialist is responsible for ensuring the highest standards of quality... ...recommendations for maintaining high standards of operation Risk Management: Assist in identifying, assessing, and mitigating risks...Risk
- ...Workplaces in Financial Services & Insurance General Liability Adjuster Primary Purpose The Commercial General Liability (CGL) Claims Adjuster... ...analysis, liability determination, litigation management, and risk transfer, particularly across multi-jurisdictional and...Risk
- CRC Group is seeking a Litigation Claims Adjuster - Complex to manage high-severity claims remotely across eligible states in the United... ...coverage, coordinate with brokers and legal counsel, and contribute to risk mitigation and regulatory compliance, with a focus on quality...RiskRemote job
$100k - $231.54k
...quality excellence, and continuous improvement while minimizing risk and enabling business objectives through collaborative stakeholder... ...required, (i.e. CPC, RHIT, CCS, or equivalent healthcare/coding credential) or must obtain credential/certification within one year...RiskHourly payFull timeTemporary workLocal area$20.5 - $27.85 per hour
..., and statistical information. Identifies and codes diagnoses and procedures for medical records according... ...-Payer) Preferred or CCS (Certified Coding Specialist) Preferred Additional Requirements CRC (Certified Risk Adjustment Coder) required -or- CIC (Certified Inpatient...RiskCasual workRemote work- ...Documentation Improvement (CDI) Specialist This is a remote position.... ...clinical documentation to improve coding accuracy, quality metrics,... ...the severity of illness, risk of mortality, and proper reimbursement... ...mortality reviews, and risk adjustment tool experience. Hiring...RiskRemote jobMonday to FridayFlexible hours
- ...years of experience Designing and executing test strategies for AI‑enabled applications Applying automation, test documentation, and risk‑based testing practices to evaluate AI systems Utilizing Quality Assurance Engineering methodologies Proficiency in Software...Risk
- ...Monitor billing exceptions, credits, adjustments, delayed invoices, and revenue or cash-flow... ...against forecast and explain variances, risks, and opportunities Support planning and... ...comparable enterprise generative-AI and coding-assistant tools in finance, accounting,...RiskContract work
- ...care gaps. Collaborate with care teams, specialists, and ancillary providers to ensure... ...effectively for accurate documentation, coding, and compliance with value-based programs... ...coding, quality metrics (HEDIS, Stars), and risk‑adjusted payment models preferred. Excellent...RiskVisa sponsorshipRelocation package
$193.28k
RISK MANAGEMENT OFFICER, ORANGE COUNTY, NY The Opportunity Orange County, NY, a growing County 50 miles north of New York City is seeking... ...a public or private agency involving insurance claims, claims adjustments, or safety loss prevention programs. Option B: A Bachelor’s...RiskLocal area
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