Risk Adjustment Coder
Albemarle Hospital
Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA! Hours: Monday - Friday, 8:00AM -5:00PM, dayshift. This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration. Overview Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality oversight audits; reviews and/or makes final coding determination for non-agreeable coding. Makes final decision on vendor-to-vendor diagnosis coding rebuttal concerns. Serves as subject matter expert on risk adjustment diagnosis coding guidelines. Coordinates risk adjustment gap elimination with clinical and quality gap elimination Maintains a reasonable fluency in workings & financial implications of applicable risk adjustment models. Education Associate degree ( Required ) Experience Medical Records Data - 1 year ( Required ) Coding - 2 years ( Required ) Certifications: One of the following certifications are required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist-Physician-based (CCS-P), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA). Must obtain Certified Risk Adjustment Coder (CRC) certification within two years of employment. Keywords: Risk Adjustment Coding & Documentation Specialist, Talroo-Allied Health, Medical Office #J-18808-Ljbffr
- ## Risk Adjustment CoderApplyremote type: Hybridlocations: SMG Administrationtime type: Full timeposted on: Posted Todayjob requisition id:... ...following certifications are required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder...RiskFull timeTemporary workWork at officeRemote workShift work
Sentara Health Plans
Virginia Beach, VA1 day ago $57.4k - $99k
...between $57,400 to $99,000 annually based on experience The Coder Quality Auditor conducts monthly and quarterly quality... ...requested . Immediately provides reports related to compliance risks when requested . Experience We Love: ~5+ years of...RiskTemporary workWork at officeImmediate startRemote workEnsemble Health Partners
Virginia Beach, VA4 days ago- ...Training vision. You will initiate investigations, analyses, risk-management studies, etc. to deliver solutions to critical problems... ...and documents. Monitors program level cost, schedule, and performance and adjusts plans as required as coordinated with sponsors....RiskRemote work
US Navy
Virginia Beach, VA1 day ago $57.97k - $103.87k
...business needs. The Opportunity As a dedicated Injury Adjuster, you will work within defined guidelines and framework,... ...What you'll do: Identifies and handles existing and emerging risks that stem from business activities and the job role. Ensures...RiskContract workH1bWork at officeRemote workRelocation package3 days per weekUSAA
Virginia Beach, VA1 day ago$69.92k - $133.62k
...business needs. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and... ...attend training, and conduct in-person inspections. Ensures risks associated with business activities are effectively identified,...RiskHourly payH1bLocal areaRemote workRelocationAfternoon shiftUSAA Careers
Virginia Beach, VA4 days ago- ...Sentara Medical Group in Virginia Beach, VA is seeking a full-time hybrid Risk Adjustment Coder to ensure accurate CMS/HHS risk adjustment documentation. The role blends remote and in-office work, with 1-2 days on site weekly and travel as needed to support team objectives...RiskFull timeWork at officeRemote work
Sentara Healthcare
Virginia Beach, VA5 days ago $55k - $100k
...Coordinating and motivating team members to achieve project milestones Risk Management : Identifying potential risks and implementing... ...Monitoring Progress : Tracking project performance and adjusting as needed Delivering Results : Ensuring the project is completed...RiskNight shift$140k - $155k
...while ensuring accountability across internal teams and external partners. The role is critical to stabilizing operations, reducing risk, and building the operational foundation required to support continued business growth.**Duties and Responsibilities*** Operational...RiskWork at officeGroundworks
Virginia Beach, VA1 day ago$169.6k - $229.46k
...Network operations experience, including network operations center, LAN/WAN Cybersecurity experience, including cyber operations, Risk Management Framework (RMF), inspections and assessments, and planning support 8570/8140 - IATIII certification, to include one or more...RiskFull timeTemporary workCurrently hiringImmediate startRemote workWorldwideFlexible hours- ...who empower people to make informed decisions to improve their risk management outcomes, modernize their benefits programs, and help... ...working at a desk most of the time, using a stand-up/sit-down adjustable desk. Exerting up to 10 pounds of force occasionally and/or negligible...RiskWork experience placementWork at office
$70.13k - $116.88k
...experience, making banking easy in an omni channel environment. Collaborates with a broad range of eco-system partners. Accountable for risk management and compliance . Builds a high performing team through the attraction, on-boarding, coaching and development of branch...RiskFull timeTemporary workPart timeWork experience placementWork at officePNC
Virginia Beach, VA5 days ago$132k - $159k
...Engineers and Subcontractors. The PM is responsible for oversight of the entire project's life cycle including budget, cost, schedule, risk, resource management and safety while providing exceptional customer service. The PM will oversee the implementation of a Raving...RiskFull timeFor contractorsFor subcontractorConsigli
Virginia Beach, VA5 days ago$175k - $250k
...Collaborate with external consultants to address CostPoint‑related issues, upgrades, and optimization. Coordinate with external risk management broker for annual insurance renewals and periodic coverage updates. Work closely with HR to coordinate employee onboarding...RiskFor contractorsWork at officeLocal areaThreat Tec, LLC
Virginia Beach, VA3 days ago- ...stakeholders and partners to translate business priorities into clear objectives, structured plans, measurable milestones, and effective risk and resource management. Responsibilities / Duties Support the delivery of moderate to large initiatives by coordinating...RiskFull time
JTH Tax , Inc.
Virginia Beach, VA1 day ago $9 per hour
...quality of your portfolio of projects, including Earned Value Management, platform execution plans, material and logistics management, risk management, metrics analysis, and continuous process improvement. Apply advanced knowledge of CVN and surface platforms and their...RiskContract workFlexible hoursSerco
Virginia Beach, VA3 days ago- ...advanced hemodynamics. Clinical Interventions: Administer high-risk medications (including cardiac drips/titration and insulin drips... ...pumps and BiPAP. Care Planning: Develop, implement, and adjust individualized care plans alongside physicians and the interdisciplinary...RiskLocal area
ATC Healthcare
Virginia Beach, VA1 day ago $19.7 - $21.91 per hour
...distance vision, color vision, depth perception, and ability to adjust focus. Work Environment The work environment characteristics described... ...parts; high, precarious places; toxic or caustic chemicals; risk of electrical shock; explosives; and vibration. The noise level...RiskHourly payFull timeLocal areaShift workWeekend workAfternoon shift- ...consistently available while balancing cost, utilization, and risk. This position serves as a subject matter expert in inventory governance... ...working with existing pivot tables (refreshing, filtering, adjusting fields). Familiarity with Power Query (Preferred) Ability to...RiskFull timeRotating shift
Sentara Healthcare
Virginia Beach, VA2 days ago $42.6k - $64k
...developing, redeveloping, acquiring and managing distinctive apartment homes in some of the best U.S. markets, and delivering outsized, risk-adjusted returns to shareholders. With equal parts experience and vision, we’ve established a leadership position rooted in our purpose...RiskFull timeWork at officeFlexible hours$165k - $195k
...on projects of at least 500 Million CAPEX ~ At least 5 years of experience managing program and project controls ~ Experience in risk management, contracting and procurement would be beneficial Additional Information This position does not offer relocation...RiskWork experience placementLocal areaWorldwideRelocation packageFlexible hoursAECOM
Virginia Beach, VA5 days ago$60k - $200k
...services organization with a global network of brokers and specialists who empower people to make informed decisions to improve their risk management outcomes, modernize their benefits programs, and help them achieve their long-term financial goals. Founded in 2011,...RiskBase plus commissionImmediate startInsurancecenterinc
Virginia Beach, VA2 days ago- ...MANTECH seeks a motivated, career and customer-oriented Assessment & Authorization (A&A), Risk Management Framework (RMF) Engineer to join our team in Virginia Beach, VA . This position is onsite. Responsibilities Reports directly to the Project Manager and supports execution...RiskWork at office
Limelight Health
Virginia Beach, VA15 hours ago - ...processes and governance, including tools and reporting Communicate project status and be the project advocate; proactively monitor risks, issues, and overall project health; develop mitigation strategies and contingency plans to address potential challenges and...RiskWork experience placementH1bLocal area
KPMG
Virginia Beach, VA4 days ago $60k - $200k
...services organization with a global network of brokers and specialists who empower people to make informed decisions to improve their risk management outcomes, modernize their benefits programs, and help them achieve their long-term financial goals. Founded in 2011,...RiskImmediate startWorld Insurance Associates LLC
Virginia Beach, VA5 days ago$60.4k - $100.7k
...developing, redeveloping, acquiring and managing distinctive apartment homes in some of the best U.S. markets, and delivering outsized, risk-adjusted returns to shareholders. With equal parts experience and vision, we’ve established a leadership position rooted in our purpose...RiskFull timeWork at office$105.23k
...critical data center projects for our clients nationwide. This high-impact role focuses on managing scope, schedule, budget, quality, and risk while coordinating multi-disciplinary teams and stakeholders across all phases of infrastructure delivery. The ideal candidate...RiskContract workWork experience placementH1bWork at officeCDM Smith
Virginia Beach, VA4 days ago- ...leadership and staff Identify and report any health and safety risks or violations Monitor hotel operations and make recommendations... ...assurance protocols Analyze feedback from customer surveys and adjust quality assurance protocols accordingly Act as a liaison between...Risk
Harrison-Group
Virginia Beach, VA3 days ago $2,565.23 per month
...images are of sufficient quality to support diagnosis. Repeat or adjust scans as necessary to improve image quality or ensure... ...between patients. Ensure proper patient positioning to prevent any risk of injury or discomfort during the scan, especially for vulnerable...RiskWeekly payShift workNight shiftSentara Healthcare
Virginia Beach, VA5 days ago$106.08k - $176.82k
...reassignment and escalation processes Ensure ownership aligns with actual work effort and technical domain Resource Coordination & Risk Management Coordinate resource needs across inter-related initiatives Support scope definition and risk assessment for technical programs...RiskFull timeTemporary workRemote workShift workSentara Health
Virginia Beach, VA3 days ago$134.26k
..., and ensure successful project delivery. Responsibilities include managing program scope, schedules, budgets, resource allocation, risk management, and quality assurance while providing regular project status updates to clients and executive leadership. The role includes...RiskFor contractorsH1bLocal areaRelocationCDM Smith
Virginia Beach, VA2 days ago
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