Risk Adjustment Specialist
Virtual Vocations Inc
Supporting the Risk Adjustment team in a fully remote capacity, the Specialist, Risk Adjustment will manage daily operations related to medical record retrieval and provider outreach while ensuring compliance with CMS and HHS deadlines. Key responsibilities: Support daily operations of Risk Adjustment, including medical record retrieval and provider outreach Maintain oversight of medical records inventory to meet or exceed retrieval goals Develop an understanding of internal workflows and tools to identify areas for improvement Required qualifications: Bachelor's degree in a relevant field or equivalent work experience 1+ years of experience in chart retrieval or provider outreach 1+ years of experience in Healthcare Operations 2+ years of experience achieving set goals
- ...Position Overview Risk Adjustment is a growing and critical field within Health Insurance Finance. This is your opportunity... ...not-for-profit health insurance company. As a Risk Adjustment Specialist, you will support ongoing processes and lead projects to ensure...Suggested
- ...To support the Burden of Illness department, the full-time Risk Adjustment Coding Specialist will perform medical record reviews, validate ICD-10-CM codes, and collaborate with healthcare providers to ensure accurate documentation and coding in a remote setting. Key responsibilities...SuggestedFull timeRemote work
- ...Job Id: 616 # of Openings: 1 Job Title: RiskAdjustment Coding Specialist Job Location: El Segundo HQ Company Description Greater Good... ...can make a lasting impact. The Role We are looking for a Risk Adjustment Coding Specialist to own retrospective CDI chart review and...SuggestedFull timeTemporary workWork at officeRemote workFlexible hours
$70k - $85k
...Risk Adjustment Coding Specialist II - Remote Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Chanell Graves Compensation: $70,000 - $85,000 / year Description We are currently...SuggestedFull timeWork at officeRemote workHome office- ...Sharp HealthCare is seeking a Risk Adjustment Reporting Specialist to support the SCMG Finance team in preserving accurate reporting across EHR, claims, and external vendor files. The role centers on validation, distribution, and analysis to enable timely performance...SuggestedRemote work
- ...Blue Cross Blue Shield of Nebraska is seeking a Healthcare Analytics professional to analyze healthcare data for Risk Adjustment programs, evaluate performance, and drive actionable insights for intervention planning and decision‑making. The role supports reporting, forecasts...Remote work
- 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...
$75k - $85k
Risk Adjustment Coding Specialist II Department: Strategy and Operations Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Brian Ramos Compensation: $75,000 - $85,000 / year Description We are currently seeking a highly...Full timeWork at officeWork from homeHome office$22 - $33 per hour
...provider actions within the Value‑Based Alert Tool (VBAT) to identify outliers and improvement opportunities.Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level...- Greater Good Health is seeking a Risk Adjustment Coding Specialist to own retrospective CDI chart reviews and strengthen coding compliance and risk adjustment optimization in our Medicare-focused primary care model. Ideal candidates have deep Medicare risk adjustment knowledge...
- Horizon Blue Cross Blue Shield of New Jersey seeks a Data Analyst for risk adjustment programs. The role involves data manipulation, vendor analytics, and creating reports to support business needs. Successful candidates will have a strong background in data analysis, programming...
- Astrana Health is seeking a Risk Adjustment Coding Specialist II to support remote chart reviews, identify coding gaps, and deliver provider education. This role emphasizes interpreting HCC data, monitoring KPIs, and providing insights to improve accuracy across payer requirements...Remote jobWork from homeHome office
- Greater Good Health in El Segundo, CA, is seeking a Risk Adjustment Coding Specialist to own retrospective CDI chart reviews, strengthen coding compliance, and optimize risk capture for our Medicare-focused care model. You will collaborate with Revenue Cycle, Clinical Operations...
- Cambia Health Solutions is hiring a Risk Adjustment Campaign Associate for a hybrid role with 3 days in the office. The position supports Medicare Advantage and Commercial risk adjustment campaigns, coordinating with the Risk Adjustment operations team and cross-functional...Work at office
$95.4k - $120k
UCLA Outpatient Clinics in Los Angeles is looking for a Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment. You will work closely with providers to ensure documentation accuracy and participate in audits. This role requires expertise in risk...- UASI is seeking a Risk Adjustment Clinical Documentation Specialist to support coding accuracy and HCC capture in a fully remote role. You will validate chronic conditions and ensure documentation integrity across outpatient records, leveraging Epic and OPAs. You’ll work...Remote job
- Astrana Health in Houston, TX is seeking a Risk Adjustment Coding Specialist II to join the Quality - Risk Adjustment team. The role conducts provider medical record audits, analyzes coding patterns, and educates providers to ensure accurate CMS payment and quality care...
- Astrana Health is seeking a Risk Adjustment Coding Specialist to support physician practices remotely from CST/EST time zones. You will review records for HCCs, educate providers, and track KPIs like HCC recapture and AWVs, contributing to program success. Requirements...Remote jobFull time
- UASI is seeking a Risk Adjustment Clinical Documentation Specialist to support coding accuracy and HCC capture in a fully remote capacity. The role emphasizes clinical judgment, analytical skills, and a commitment to documentation integrity reflecting patient severity and...Remote job
- UASI is seeking a Risk Adjustment Clinical Documentation Specialist to advance documentation accuracy in a fully remote capacity. The role focuses on supporting coding accuracy, HCC capture, regulatory compliance, and clinical documentation integrity in outpatient settings...Remote job
- ...range reflects the Northern CA region. Lower salary ranges will apply for other labor markets outside of NCAL.Support Health Plan Risk Adjustment strategy through data analysis, performance monitoring, and business insights that drive operational excellence, compliance...
- ...Risk Adjustment Quality Specialist The Risk Adjustment Quality Specialist plays a vital role in coordinating and supporting prospective, concurrent, and retrospective reviews to assist with patient care management. The position provides education and facilitates chart...Remote workWork from home
- ...Health, you will connect with people and communities in need to provide your expertise and act as their advocate. You will help them adjust to changes and challenges in their lives and to access services and resources to improve their quality of life.CorporateAs a caring...Live in3 days per week
- ...Risk Adjustment Compliance Coding Specialist (Consultant) The Risk Adjustment Compliance Coding Specialist (Consultant) helps to ensure organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medi-Cal (Medicaid), and Medicare Advantage...Work at office2 days per week
- ...expert CDI consulting. As we continue to grow our service offerings, we’re looking for experienced and motivated Risk Adjustment Clinical Documentation Specialist professionals to join our dedicated team in a fully remote capacity. As a Risk Adjustment Clinical...Remote work
- UASI is seeking a Clinical Risk Adjustment Documentation Specialist to support coding accuracy, HCC capture, regulatory compliance, and CDI initiatives in a fully remote capacity. The role requires strong clinical judgment, analytical skills, and a commitment to documentation...Remote job
$99k - $124k
...re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through... ...click here. What You'll DoWe are seeking a Lead Analyst, Risk Adjustment Analytics to join our high-performing, insights-driven team....Work at officeRemote workWork from homeFlexible hours2 days per week- MVP Health Care is seeking a Health Analytics Specialist to advance Medicare, Commercial Exchange, and Medicaid/HARP analytics and reporting. The role focuses on risk adjustment initiatives, data-driven targeting, and translating complex data into actionable insights. Proficiency...
- University HealthCare Alliance (dba Stanford Medicine Partners) is the medical foundation of Stanford Health Care and Stanford Medicine. Stanford Medicine Partners was born out of the aspiration for Stanford Medicine and local, leading providers to partner together to bring...Local area
- A healthcare services company is seeking a Medical Records Retrieval Specialist to ensure proper clinical documentation through quality assurance reviews and ICD-9/10 coding. This role involves significant travel (75%) to provider offices. Candidates must have a working...Work at officeWork from home
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