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- Description PRIMARY PURPOSE: The Risk Adjustment Coder plays a critical role in ensuring accurate documentation and coding of chronic conditions to support value-based care initiatives and optimize risk scores for reimbursement. This position focuses on Hierarchical Condition...Risk
- Job Overview We’re ChenMed - a family‑owned, physician‑led practice transforming healthcare for seniors. Join us as a Risk Adjustment Coder and help improve the quality of care while supporting our patients and team. The role involves reviewing medical records, identifying...RiskWork at officeRemote work
$193k - $242k
...healthcare. Role Overview As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap, and execution... .... Background in working with provider documentation teams, coders, or concurrent review vendors. Clinical experience or deep...Risk- Overview Medical Director Opportunity - Medicare Risk Adjustment HCC Review - Puerto Rico (Option to be Florida Based)!! Option to either live... ...record reviews in tandem with a certified professional coder at provider locations or at company9s offices Facilitate query...RiskFull timeLive inWork at office
- ...seeking a detail-oriented and proactive Claims Examiner to join our risk management team. In this role, you will be responsible for... ...carriers Required Qualifications: Florida 6-20 All-Lines Adjuster License (or ability to obtain within 90 days of hire) At least...RiskPermanent employmentContract workTemporary workWork at office
$77.97k - $141.37k
JOB DESCRIPTION Job Summary Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources...RiskRemote jobWork experience placement$77.97k - $140k
JOB DESCRIPTION Job Summary Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate...RiskRemote jobWork experience placement$77.97k - $140k
Job Summary Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and...RiskRemote jobWork experience placement- InnovaCare Management Services Company, LLC is seeking a Manager, Risk Adjustment Operations to strengthen and improve practice operations, resulting in stronger patient acuity capture and improved population health management. The successful candidate will provide operational...RiskWork at office
- Manager, Risk Adjustment Operations As a Manager, Risk Adjustment Operations you'll provide operational services to strengthen and improve practice operations that result in stronger patient acuity capture and improved population health management. You'll use your subject...RiskWork at officeRemote workFlexible hours
$50.2k
...recommends process improvements for efficiencies. May provide guidance to Associate level employees. This role sits within our Risk Adjustment team - it is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk...RiskFor contractorsWork at officeLocal areaRemote work- Risk Adjustment Coding Specialist REMOTE Formed in 2008 and headquartered in Fort Myers, Florida, with offices in Florida, North Carolina, and Texas, Millennium Physician Group (MPG) is the largest independent physician group in the state of Florida and one of the largest...RiskRemote work
$141.44k - $212.16k
...lead a key execution component of a critical program focused on Adjustment Reduction and Data Automation, directly tied to key regulatory... ...third lines of defense. Effectively communicate program status, risks, and issues. Regulatory Interaction: Serve as the primary point...RiskFull time$77.97k - $155.51k
...DESCRIPTION Job Summary This Sr. Analyst, Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab...RiskRemote jobWork experience placement- ...Competencies: ACCOUNTABILITY, ACCURACY (DRG), ACCURACY - CODER, ACCURACY - OUTPATIENT, ANALYSIS AND DECISION MAKING, CUSTOMER... ...CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS),...RiskWork experience placementWork at officeLocal areaShift work
- JOB SUMMARY The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes complex encounter inbound/outbound process issues, using data from internal and external sources to provide insight...RiskWork experience placementImmediate start
$145k - $170k
...professional, educational and life experiences to realize our bold vision for healthcare. Role Overview As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and execution for Datavant’s Retrospective Risk Adjustment Coding products...Risk$68.7k - $123.7k
Senior, Compliance Risk Adjustment Analyst Join to apply for the Senior, Compliance Risk Adjustment Analyst role at Centene Corporation Senior, Compliance Risk Adjustment Analyst Join to apply for the Senior, Compliance Risk Adjustment Analyst role at Centene Corporation...Risk16 hoursFull timePart timeWork at officeRemote workWork from homeFlexible hours$117.2k - $222.5k
...ll also conduct competitive benchmarking and identify emerging risks and opportunities in a rapidly evolving healthcare landscape. This... ...experience. Bonus Points Experience in Medicare Advantage Risk Adjustment highly preferred What You\'ll Get The opportunity to work at...Risk- ...Coding Certification from AHIMA or AAPC ~3+ years CURRENT Inpatient Coder work experience in an acute care hospital ~ EPIC/3M experience a plus ~ This is facility coding (no risk adjustment or profee) ~ The coders should have 3 years current inpatient coding experience...RiskWork experience placementRemote work
$19.89 - $27.85 per hour
...Required/ Preferred and/or CPC (Certified Professional Coder) Preferred or COC (Certified Outpatient Coding)... ...Preferred or Additional Requirements CRC (Certified Risk Adjustment Coder) required -or- CIC (Certified Inpatient Coder) required...RiskFull timeCasual workRemote workShift work$19.89 - $27.85 per hour
...certifications from AAPC or AHIMA will be considered. CPC (Certified Professional Coder) COC (Certified Outpatient Coding) CPC-P (Certified Professional Coder-Payer) CRC (Certified Risk Adjustment Coder) CIC (Certified Inpatient Coder) CCS (Certified Coding...RiskFull timeCasual workRemote workShift work- ...coding experience. Physician Billing Credentials For Physician Billing: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS), Certified Coding Specialist -...RiskFull timeWork experience placementWork at officeLocal area
- ...Role Description: The Certified Medical Coder is responsible for analyzing provider documentation... .... Skills Required: Minimum 2 years of risk coding experience, preferably in primary... ...(CPC) required; Certification in Risk Adjustment Coding (CRC) preferred High school...RiskFull timeWork at officeRemote workWork from homeShift work
- Auditing Manager CPC Coders Hybrid work setting, Florida residency required As Mount Sinai grows, so does our legacy in high-quality health... ...the institution. Analyze audit findings and identify trends, risks, and opportunities for improvement. Team Leadership &...RiskWork at office
- ...industry standard for global medical cost containment and medical risk management solutions. Learn more here . Iris, Powered by... ...here . What you’ll be doing. Job Summary: The Liability Claims Adjuster will be reporting to the Supervisor, Liability Claims. This position...RiskTemporary workWork at officeLocal areaWork from homeMonday to Friday2 days per week3 days per week
- Specialist III, Medical Coding Adjustment Join to apply for the Specialist III, Medical Coding... ...Hierarchical Condition Categories (HCC)/Risk Adjustment. Advanced knowledge and understanding... ..., preferred. Certified Procedural Coder (CPC), CRC designation preferred. Certified...RiskFull timeTemporary workRemote workMonday to Friday
- Medical Coding Adjustment Specialist II Millennium Physician Group Full Time (Monday-Friday 8... ...Hierarchical Condition Categories (HCC)/Risk Adjustment. • Possesses advanced knowledge... ...experience, preferred. • Certified Procedural Coder (CPC), CRC designation preferred. •...RiskFull timeTemporary workRemote workMonday to Friday
$50k
...Description General Liability Claims Specialist · New York Adjusters License Needed Work-From-Home Comprehensive Benefits... ...benefits package. Company Description North American Risk Services (NARS) is a premier third-party claims administrator that...RiskWork at officeWork from home- ...Position Summary The ideal candidate is an experienced, all-lines adjuster, with at least one year of PIP handling experience for Florida... ...claims professionals, to resolve complex claims and mitigate risk effectively. · Identify opportunities for process improvement...RiskWork at office
