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- ...Leading product strategy for the risk adjustment ecosystem, the full-time salaried Director of Risk Adjustment will define and execute the product roadmap, enhance clinician experience through technology, and ensure compliance with evolving CMS regulations in a fully remote...RiskFull timeRemote work
Virtual Vocations Inc
United States2 days ago - ...Reviewing medical records and validating diagnosis information, the full-time Risk Adjustment Coding Specialist will work remotely to ensure accurate risk adjustment coding while adhering to established guidelines and departmental procedures. Key Responsibilities Review...RiskFull timeRemote work
Virtual Vocations Inc
United States5 days ago $31.03 - $36.03 per hour
...degree, an additional 2 years of relevant work experience is required in addition to the required work experience. ~3 years of risk adjustment and/or hierarchical condition category coding experience. ~ Strong knowledge of diagnosis code validation, coding...RiskTemporary workWork experience placementRemote workCynet Systems
United States3 days ago- Vytwo in Dallas, TX seeks a Risk Adjustment Coding Auditor for a 6-month engagement to support CMS RADV audit passes. The role requires a CPC and CRC certification and 5+ years of risk adjustment experience, with proficiency in MS Office. The team will run first and second...Risk
$100k - $231.54k
...is seeking a Lead Director, Informatics (Performance Reporting & Insights) to lead the development and delivery of enterprise risk adjustment analytics and business intelligence solutions. This role transforms complex clinical, operational, and risk adjustment data into...RiskHourly payFull timeTemporary workWork experience placementLocal area- Blue Cross Blue Shield of Massachusetts, Inc. is seeking a Risk Adjustment Provider Performance Consultant to design and execute provider engagement and improvement strategies within our risk adjustment program. Reporting to the Senior Director of Risk Adjustment and Analytics...Risk
- ...experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent... ...opportunity employer. Responsibilities This Senior Casualty Claim Adjuster role requires deep, proven casualty claim experience and is responsible...RiskFull timeWork experience placementWork at officeRemote workFlexible hours
Berkley One (a Berkley Company)
Scottsdale, AZ1 day ago - Blue Cross Blue Shield of Massachusetts is seeking a Risk Adjustment Provider Performance Consultant to design and execute provider engagement and improvement initiatives. This high-impact role bridges clinical documentation, data analytics, and network strategy under the...Risk
- 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
- ...Location: Birmingham, Alabama Job Summary The Risk Adjustment Specialist ensures all ICD-10 codes are documented for the assignment of valid and accurate HCCs for each record reviewed for submission to the Centers for Medicare & Medicaid Services (CMS). Other responsibilities...RiskImmediate startFlexible hours
VIVA Health
Birmingham, AL5 days ago - A public agency in California is seeking a Workers' Compensation Claims Adjuster II to join the Risk Management team. This role involves investigating claims, administering benefits, and working closely with legal counsel. The County values a diverse workforce and offers...RiskRemote job
$96.13k - $140.19k
...Hi, we're Oscar. We're hiring a Manager, Risk Adjustment, Provider Partnerships to join our Strategic Planning team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar...RiskFull timeContract workRemote workWork from homeHome office- Astrana Health seeks a Risk Adjustment Coding Specialist II to support the Houston market. You will review medical records to identify coding gaps, deliver education to providers, and track KPI metrics to improve program outcomes. The role requires AAPC CPC/CRC certifications...RiskRemote job
- Astrana Health Management is seeking a Certified Risk Coder for a remote, US-based role to support value-based care and CMS risk adjustment initiatives. The successful candidate will review records, validate ICD-10-CM codes, and perform HCC coding analyses to improve documentation...RiskRemote job
- ...settings. This position requires a high school diploma or GED, along with 3+ years of coding experience and active certification from AAPC or AHIMA. Strong experience in CMS HCC Risk Adjustment Models is essential, along with advanced coding knowledge. #J-18808-LjbffrRiskFull timeRemote work
ALLMED Staffing
United States4 days ago - ...Bargaining Unit: Local 21 - Non-Supervisory Management Contra Costa County is seeking one (1) Workers' Compensation Claims Adjuster II to join our Risk Management team. The County Workers’ Compensation Program is unique as it is not only self‑insured, but also self‑...RiskPermanent employmentFull timeTemporary workWork at officeLocal areaImmediate startRemote work
County of Contra Costa
Martinez, CA2 days ago $143.62k - $229.79k
...Overview As a Consulting Actuary - ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments...RiskBlue Cross and Blue Shield of North Carolina
Brooklyn, NY2 days ago- ...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, policy...RiskFull timePart timeSeasonal work
Great American Insurance Company
Louisiana, MO5 days ago - ...Property Claims AdjusterTokio Marine HCC - Public Risk Group, a member of the Tokio Marine group of companies, is a market leader in... ...in multiple states.Role OverviewWe are seeking a Property Claims Adjuster to handle low-to mid-level commercial first-party property claims...RiskWork at officeLocal area
Tokio Marine HCC
Troy, MI1 day ago $100k - $180k
...experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent... ...lines property claims for high-net-worth clients. As a General Adjuster (Field Adjuster), you will be responsible for quality handling...RiskFull timeFor contractorsW. R. Berkley
New York, NY4 days ago$130k - $145k
...sophisticated individuals and families who require world-class risk and claims management customized to their needs, a team of select... ...property claims for high-net-worth clients. As a Field Property Claims Adjuster (aka General Adjuster), you will be responsible for quality...RiskFull timeFor contractorsBerkley One (a Berkley Company)
Centerport, NY1 day ago- ...Job Description: A prominent insurance organization specializing in claims handling and risk management seeks a highly skilled Senior Claims Adjuster to join its dedicated claims team. This role is ideal for an experienced professional with a strong background in commercial...RiskFull time
The Jacobson Group
Texasa month ago - ...Job Description Job Description JOB DESCRIPTION JOB TITLE: Sr. Manager, Risk Adjustment FLSA STATUS: Exempt DEPARTMENT: Quality Improvement and Risk Adjustment REPORTS TO: Sr. Director, Quality Improvement, Risk Adjustment, and Health Analytics AUTHORITY...RiskWork at officeShift work
Imperial Management Administrators Services Inc
Pasadena, CA25 days ago $134.6k - $230.8k
Optum NY, is seeking an Executive Director of Risk Adjustment join our team in New York, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision...RiskMinimum wageFull timeWork experience placementLocal areaWork from home$100k - $102k
...Workers' Compensation Claims Adjuster IIIAvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32 states. With nearly 700...RiskPermanent employmentWork at officeRemote workAS&G Claims Administration
Rocklin, CA1 day ago- ...Memorial Health providers with their patients’ needs in mind. We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the strategy, execution and performance of Medicare...RiskWork at office
Central Mass Health LLC
Worcester, MAa month ago - Blue Cross and Blue Shield of North Carolina is seeking a Consulting Actuary specializing in ACA Risk Adjustment. You will lead pricing strategies and actuarial initiatives for multiple business segments, evaluating care models and designing sophisticated insurance products...Risk
- ...As a leading provider of crop insurance and other agricultural risk management tools, we recognize that our success is derived directly... ...?** AgriSompo has a unique opportunity for a **Crop Insurance Adjuster** to join our **Upper Midwest team**, supporting our **Multi-Peril...RiskFull timeWork at officeRemote workWorldwideHome officeFlexible hoursWeekend work
Sompo Holdings
Fargo, ND4 days ago $143.62k - $229.79k
...Remote Flex - Missouri Remote Flex - Alabama Full time RQ0018005 Job Description As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities...RiskFull timeLocal areaRemote workFlexible hoursBlueCross BlueShield of North Carolina
United States3 days ago$70k - $85k
...Job Description Job Description Description We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Orange County market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify...RiskWork at officeAstrana Health, Inc.
Orange, CAa month ago
