Certified Medical Coder - Risk Adjustment & Audits
RELI Group
RELI Group in Windsor Mill, MD is seeking an experienced Medical Coder to support Risk Adjustment and Medicare Part C audits. You will code inpatient, outpatient, and physician office records according to ICD-9-CM/ICD-10-CM guidelines, while maintaining high accuracy and productivity. The role requires a minimum of 1 year of coding experience, active credentials (CPC/CCS/RHIA/RHIT), and proficiency with Microsoft Office. CRC certification is a plus. #J-18808-Ljbffr RELI Group
- Blue Shield of California seeks a Risk Adjustment Compliance Coding Specialist (Consultant) to ensure accurate coding for ACA, Medi-Cal, and... ..., assign ICD-10-CM codes including HCCs, and support audits to maintain regulatory compliance and proper reimbursement. The...Risk
- Blue Shield of California is seeking a Risk Adjustment Compliance Specialist, Principal to ensure compliance across ACA Marketplace, Medicaid, and Medicare Advantage lines. You will audit, monitor, and improve risk adjustment processes, partnering with coding, clinical...Risk
$102k - $115k
...$115,000 / year Department: Quality - Risk Adjustment Description Astrana Health is seeking Manager... ...-home health assessments, embedded NP, medical chart retrieval, HCC risk adjustment... ...program and the vendor driven AWV program. Audit the chart review outcomes provided by...RiskWork at officeRemote work$45k - $55k
...We are seeking a detail-oriented and experienced Medical Coder to support Risk Adjustment and Medicare Part C audits by accurately coding inpatient, outpatient, and... ...ICD-9-CM/ICD-10-CM coding guidelines. Must be a certified coder who is credentialed by a recognized credentialing...RiskContract workFor contractorsInternshipLive inWork at office$70k - $85k
Risk Adjustment Coding Specialist II - Orange County Department... ...diagnostic data from medical records to verify that... ...and/or coding quality audits of medical records to... ...assignments. Support coder training and orientation... ...AHIMA certification - Certified Coding Specialist (CCS...RiskFull timeWork at office- The Risk Adjustment Compliance Specialist, Principal is responsible... .... This role involves auditing, monitoring, and evaluating... ...highly preferred Requires a certified Risk Adjustment Coder (CRC), Certified... ..., Healthcare Compliance, Medical Coding, or related area Requires...RiskFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
$123.09k - $184.8k
Your Role The Risk Adjustment Compliance Coding Specialist (Consultant... ..., and integrity of medical coding for risk adjustment... ...organizational policies. Quality Audits: Independently conduct... ...field is preferred Certified Risk Adjustment Coder (CRC), Certified Professional...RiskFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week$102k - $115k
A healthcare organization is seeking a Manager - Risk Adjustment to lead risk adjustment initiatives, ensuring accurate documentation and... ...healthcare framework. You will oversee operations, coordinate with medical providers, and manage incentive programs. The role requires a...RiskRemote job$200k - $285k
...balance. Is This the Career for You? The Chief Risk Officer (CRO) is a key member of the... ...risk management, compliance, internal audit, vendor management, corporate insurance,... ...A Master of Business Administration and Certified Internal Auditor is preferred. EXPERIENCE...RiskWork at officeLocal area- ...professional to support end-to-end retrospective chart review and risk adjustment analytics in Oakland, CA. The role emphasizes AI-enabled... ...Compliance, and Risk Adjustment teams to ensure accuracy and audit readiness in a hybrid work model. #J-18808-Ljbffr Blue Shield...Risk
$94k - $151k
...competitive analysis, network analysis, risk adjustment, trend, actuarial benefit value... ...skills and experience. Benefits include medical insurance, 401(k), vision insurance, paid... ...type: Full-time Job function: Accounting/Auditing Industry: Staffing and Recruiting #J-1...RiskFull time$24.66 - $33.94 per hour
RCIS Crop Claims Specialist or Claims Crop Field Adjuster CA 135906 Zurich is currently looking for a to join our Rural Community Insurance... ...plans through the United States Department of Agriculture's Risk Management Agency. Together with RCIS agents, we protect America...RiskHourly payFull timeTemporary workSummer workWork at officeLocal areaRemote workVisa sponsorshipFlexible hours- ..., regulatory compliance, and disciplined risk management. This role reports to the Vice... ...accurate, and well-supported responses to audits, inquiries, and regulatory communications... ...and evaluating direct reports. Licensed Certified Public Accountant, Certified Management...RiskWork at officeLocal area2 days per week
$123.09k - $184.8k
...and develop analysis, assess risk and population risk scores and... ...Coordinate, prepare, perform, and audit actuarial analyses to assist... ...forecasting, reserving, risk adjustment, provider contracting, or related... ...need. For employees with medical conditions that may impact their...RiskFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week$105k
...hospitality. Job Summary The IT Governance, Risk and Compliance Manager is responsible for... ...supporting SOX and IT General Controls, audit readiness, governance documentation, and... ...Preferred Certifications Include Certified Information Systems Auditor (CISA) Certified...RiskHourly payTemporary workLocal area$75k - $87.88k
...budgeting, financial planning and analysis, risk management, information technology,... ...accounting, financial reporting, compliance, audit coordination, treasury activities, and... ...from an accredited institution required. Certified Public Accountant (CPA) or master’s in business...RiskTemporary work$157.5k
...Summary The Senior Director, IT Governance, Risk and Compliance, is responsible for... ...a focus on SOX and IT General Controls, audit readiness, governance documentation, benchmarking... ...Preferred Certifications Include Certified Information Systems Auditor (CISA) Certified...RiskHourly payTemporary workLocal area$6,320 per month
...employees that includes an array of medical plans, choice of dental plans,... ...policies and procedures, audits and reconciliations, and staff... ..., mitigating institutional risk, and ensuring ethical and compliant... ...work occasional holidays and adjust working hours to meet special...RiskFull timeWork experience placementCasual workWork at officeImmediate startWeekend workAfternoon shift- ...non-destructive testing services; seismic risk assessment services; materials analysis... ...reconstruction experience and be ACTAR certified or have a Bachelor of Science in Mechanical... ...: insurance carriers, attorneys, and/or adjusters Minimum of 5 year experience in...RiskRemote workRelocationFlexible hours
- ...Group Holdings, Inc. is seeking a Senior Director, IT Governance, Risk and Compliance to lead SOX and ITGC compliance efforts across... ...enterprise. You will partner with Legal, IT, Security, Internal Audit, and Finance to strengthen controls and ensure audit readiness....Risk
- ...and the Litigation team Support supplier risk management throughout the supplier... ...arbitration fees, contributions, account adjustments, and tax filings Review, reconcile, and... ...Manager course and become Supplier Manager certified At least 3 years of Excel experience Working...RiskMonday to FridayFlexible hours
$3,861 - $6,276 per month
...ANALYST I $3,861.00 - $6,276.00 # of Positions: 1 Telework: Hybrid Job Type: Permanent, Full Time Department Information Utility Audits, Risk & Compliance/ Risk and Compliance Branch (RCB) : Job Description And Duties Under the direction of the Program and Project...RiskPermanent employmentFull timeRemote work$200k - $285k
A community-focused financial institution in California is looking for a Chief Risk Officer. This key executive role involves managing enterprise risk, compliance, internal audit, and business continuity management. The ideal candidate should have at least 15 years of experience...Risk- ...The VP, Internal Audit is a highly visible senior leadership role... ...SOX compliance, enterprise risk management, and regulatory oversight... ...in Medicare Advantage risk adjustment, RADV compliance, and... ...healthcare and claims environments.Certified Internal Auditor (CIA) —...Risk
$17 - $25 per hour
...confidently assess collateral risk, interpret complex appraisal... ...comparable sales selection, adjustments, and overall appraisal quality... ...management decisions. Participate in audits, quality control reviews, and... ...Residential Appraiser, Certified Residential Appraiser, or SRA...RiskHourly payLocal areaRemote workWork from home- ...policies. Providing actuarial support for market conduct reviews and audits, clearly explaining pricing methodologies, data sources and... ...underwriting, claims, product and IT teams to identify emerging risks and claims trends and reflect these appropriately in pricing...RiskRemote work
- A leading risk management firm based in California seeks a Claims Manager to oversee and manage claim files effectively. The ideal candidate... ...include conducting thorough investigations, collaborating with medical case managers, and ensuring compliance with applicable...Risk
$130k - $190k
...Claims or Underwriting Support area OR Zurich Certified Insurance Apprentice including an... ...nationwide market range and has not been adjusted for geographic differentials pertaining to... ...insurance. Zurich North America is a leader in risk management, with over 150 years of...RiskFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workVisa sponsorship$158k - $258k
...Ensure best practices for regular audits of earnings, payroll taxes,... ...errors or compliance risk. Provide subject matter expertise... ...verbal communication skills. Certified Payroll Professional (CPP)... ...accommodations are modifications or adjustments to the application or hiring...RiskFor contractorsWork at officeLocal areaRemote workWork from homeFlexible hours- Blue Shield of California is seeking an Internal Audit Fraud Advisor to serve as a fraud subject matter expert, supporting audits, proactive... ...and advisory efforts to prevent, identify, and remediate fraud risk enterprise-wide. The role partners with auditors, compliance,...Risk
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