Risk Adjustment Coding Auditor - Medicare & HEDIS Expert
CommunityCare HMO, Inc.
CommunityCare HMO, Inc. is seeking a Clinical and Risk Adjustment Auditor in Tulsa, OK. This role involves conducting audits for clinical and risk adjustment documentation for Medicare Advantage and ACA Programs, ensuring coding accuracy and regulatory compliance. The ideal candidate will hold a coding certification, have extensive coding experience, and be proficient with CMS guidelines. The position requires strong analytical skills and a meticulous approach to auditing. #J-18808-Ljbffr CommunityCare HMO, Inc.
- ...POSITION SUMMARY As an Auditor I at TEAM, you are responsible for supporting the... ...- Ability to embrace change and adjust to new business processes and policies... ...Ability to analyze situations and identify risks or discrepancies # Detail Oriented -...RiskWork at office
- ...Records Retrieval Specialist is responsible for requesting, collecting, organizing, and processing medical records to support Risk Adjustment, HEDIS, and Quality Improvement initiatives. This role manages all outbound and inbound record requests, retrieves documentation...HEDISRiskWork at office
- ...Join Davies Risk Services as a Premium Auditor - No Experience Required! Are you a self-starter who thrives on independence, loves working with... ...payroll, sales journals, cost records, etc. Verifying class codes based on business operations Watch our Premium Audit...RiskFor contractors
- ...electricity. It’s essential to hire a contractor familiar with local codes and utility company requirements. The right contractor will... ...to problem-solving can reveal their ability to adapt and manage risks effectively. A contractor who can anticipate potential issues and...RiskContract workFor contractorsWork at officeLocal area
- ...salary schedules provide career increment adjustments based on education/experience and/or... ...this role ensures accurate general ledger coding and reporting in line with the State of... ...Ability to work proactively and anticipate risks or needs • Ability to build and...RiskWork experience placementWork at office
$42k - $46k
...you for jobs well done. Develop ability to adjust management approach as needed with... ...members while modeling appropriate dress code and company standards. Focuses continued learning... ...reviews along with operational knowledge, risk management and loss prevention, financial...RiskLocal areaFlexible hoursShift work- ...manner. Complies with all company safety and risk management policies and procedures.... ...flexible schedule. Must comply with any dress code requirements. Must be able to work nights,... ...vision, depth perception and the ability to adjust focus, with or without corrective lenses....RiskContract workFlexible hoursShift workNight shiftAfternoon shift
- ...production. The role coordinates detailed readiness activities, monitors risks, resolves issues, and provides data-driven insights on capacity... ...with the ability to synthesize complex information.* Ability to adjust priorities quickly and make decisions in a fast-paced...RiskWork at officeShift workAfternoon shift
$175k - $250k
...manage all aspects of the practice, including your team, billing and coding, supervising physician, malpractice insurance, EMR, payroll,... ...practice and its accounts receivable (A/R) to you, minimizing risk. Approximately 36 months from your first day with Triad Complete...RiskFull timeLocal area- ...Location: Tulsa -TUL Areas of Interest: Project Management; Data; Risk Management Pay Transparency Salary Range: Not Available... ...requirements. You will monitor progress through status reports, adjust plans as needed, and support testing and quality assurance. You...Risk
$20 per hour
...including personnel, leasing, maintenance, financial, administration & risk management in the absence of the Community Manager. As an onsite... ...and confined spaces, work in an overhead position and reach, adjust or move objects of up to 25 lbs. in all directions, lift and...RiskHourly payPermanent employmentFull timeFor contractorsNight shiftWeekend work- ...medication management Assist with complex or high-risk clinical decision-making Support... ...and payer requirements Ensure proper E&M coding and billing compliance Model and reinforce... ...& Substance Abuse Services, Medicaid, Medicare, and through charitable gifts. We also accept...RiskContract work
$175k - $250k
...all aspects of the practice, including: your team, billing and coding, supervising physician, malpractice insurance, EMR, payroll, advertising... ...the practice will have been operating successfully, minimizing risk. You'll begin to reap the rewards of your hard work, with...RiskFull timeWork at officeLocal areaShift work$90k - $110k
...Senior Workers Compensation Analyst. The Senior Workers Compensation Analyst oversees workplace injury cases, claims, and organizational risk strategies. This individual collaborates with leadership and internal stakeholders to strengthen compliance, improve reporting and...RiskLocal area- ...to prepare RFP submittals. 17. Perform risk management to minimize project risks and report... ...and understanding of building and zoning codes, accessibility standards, and code review... ...include close vision and ability to adjust focus. Cyntergy has a beautiful work facility...RiskContract workFor contractorsWork experience placementLocal areaNight shift
- ...Job Title: Risk ManagerIndustry: Oil and GasLocation (city, state): Tulsa, Oklahoma (in office)Benefits: This position is eligible for medical, dental, vision, life insurance and 401(k).About Latshaw Drilling:Latshaw Drilling is a premier privately held land drilling...RiskFor contractorsWork at officeLocal area
- BOK Financial Corporation is seeking a Business Initiative Consultant II to drive the evolution of our Fraud Risk Management programs. In this highly collaborative role, you will lead cross-functional initiatives aimed at improving risk processes and efficiency. The ideal...RiskRemote job
- ...Your future role at a glance Location: Tulsa, OK Facility: St John Health System Department/Specialty: Risk Management Schedule: Full time, Days Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system...RiskFull timeLocal area
- ...reports to the Medical Director with compliance rates and trend data Coordinate with QA/QI to ensure registry data feeds CCBHC NOMs, HEDIS, and PPS reporting Review next‑day appointments and flag charts in Arize with pending labs, overdue screenings, or abnormal results...HEDISPermanent employmentFull time
$142.6k - $261.5k
...platforms including mobile, web, and tablets. You will engage in coding, programming, and creating specifications to deliver development... ...solutions, and projects, ensuring a strong focus on quality and risk management. This role presents exciting challenges and...RiskFull timeSummer holidayLocal areaFlexible hours- ...Your future role at a glance Location: Tulsa, OK Facility: St John Health System Department/Specialty: Risk Management Schedule: Full time, Days Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and...RiskFull timeLocal area
- ...waiting on orders—you’re leading care. You assess, decide, and adjust in real time, owning outcomes for your patients. ~ Complex, High... ...comprehensive in-home assessments to evaluate clinical status, risks, and goals of care Develop and manage individualized care plans...RiskFull timeFlexible hours
- ...strategies. The ideal candidate will have a PharmD, clinical pharmacy experience, and be proficient in data analysis, especially with HEDIS and CMS standards. Responsibilities include leading quality initiatives and providing education to healthcare providers. #J-18808-...HEDIS
- Position Title: Professional Coding Specialist III Department: Revenue Integrity Remote... ...General Description Senior subject matter expert responsible for the most complex pro fee... ...Code and resolve the most complex, high-risk professional encounters including specialty...RiskFull timeRemote workFlexible hours
- ...Edison Health Solutions, LLC is seeking a Funding Auditor to oversee and audit funding processes, ensuring accurate reconciliation of transactions and claims. This role involves reviewing stop-loss recoveries, coordinating fund transfers, and conducting detailed audits...
- A leading health solutions provider is seeking a certified Nurse Practitioner to conduct in-home wellness risk adjustment assessments in Tulsa County, Oklahoma. Candidates must possess a valid NP License and preferably have experience in patient care and in-home assessments...RiskReliefFlexible hours
$1,705 per week
...anti-seizure medications for patients at risk of or experiencing seizures and ensure continuous... ...Communicate effectively with the team to adjust care plans based on the evolving needs of... ...Participate in rapid response teams and code blue situations, providing immediate care...RiskFull timeContract workImmediate startShift workNight shift- ...internal audit department, incorporating tools designed to access risk, and in preparation of an annual internal audit plan. -Keeps... ...strengthen audit efficiency and coverage. -Assists external auditors when required in conducting the annual external audit for SFHS to...Risk
- ...Tulsa - TUL, Dallas - DAL, Oklahoma City - OKC Areas of Interest: Risk Management, Compliance Pay Transparency Salary Range: Not... ...Assess: Review outside business activities, employee accounts, and code of ethics adherence Track: Monitor remediation efforts to ensure...RiskWork at office
$1,677 per week
...or healthcare team. Provide pain management interventions and adjust care based on patient response and comfort level. Telemetry... ...necessary. Ensure patient safety by regularly assessing for fall risks, managing medications safely, and preventing hospital-acquired...RiskFull timeContract workImmediate startShift workNight shift
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