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- ...vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses... ..., ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in...RiskFull timeRemote workFlexible hours
- **Become a part of our caring community and help us put health first** The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government...RiskBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeShift workMonday to Friday
- ...do it all with heart, each and every day. CVS Health has an exciting opportunity for an Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will support data analysis, predictive modeling, and evaluation reporting within our Medicaid...RiskHourly payFull timeTemporary workWork experience placementLocal areaFlexible hours
- ...Highmark Inc. **Job Description :** **JOB SUMMARY** This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government...RiskFor contractorsWork at officeLocal area
- ...realize our bold vision for healthcare. The Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality of employees' work, process improvements and clear communication...RiskRemote workFlexible hours
- **JOB DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment program valuation. Maintain SQL/Databricks model, estimate valuations, and analyze results. Extract, analyze, and synthesize data from various sources...RiskWork experience placementRemote work
- ...optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** This Product team is a part of the Risk Adjustment and Quality Domain of Optum Insight. It includes Retrospective and Prospective services and a total team of 45 members - here and...RiskMinimum wageFull timeWork experience placementLocal areaRemote work
- ...realize our bold vision for healthcare. The Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality of employees' work, process improvements and clear communication...RiskRemote workFlexible hours
- ...professional, educational and life experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and execution of analytics capabilities that power Datavant's risk...Risk
- ...**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...RiskWork experience placementRemote work
- **Become a part of our caring community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and strategic planning support for business segments and the company at large. The Director, Risk Adjustment Strategy...RiskFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome office
- ...reports, meetings, and status updates, etc.). + Identify project risks that impact the quality of our product and services delivery to... ...on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a diverse...Risk
- **Become a part of our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's adherence to governmental and contractual requirements, with a focus on risk adjustment operations. The role involves varied...RiskFull timeTemporary workApprenticeshipRemote work
- Commercial Large Loss, National General Adjuster - Property 122211 Zurich North America is hiring an Commercial Large Loss, National General... ...Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a...RiskFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeVisa sponsorship
- ...MRA programs and related STP operations + Identify process gaps, risks, and opportunities for efficiency or quality improvement +... ...healthcare operations, preferably with exposure to MRA or risk adjustment + Strong understanding of financial concepts (budgeting, ROI, cost...RiskFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome office
- ...seeking a Manager to lead our team of Certified Professional Coders (CPC). The Manager is responsible for overseeing and managing... ...Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC) Licensed Clinical Social Worker (LCSW) Licensed Independent...RiskHourly payFull timeTemporary workLocal areaFlexible hours
- ...Practice Coding Team** is looking for an **experienced Medical Coder with General Medicine: Multi-Specialty experience.** This is a... ...Medicine (some HCC) Coding experience** with Certified Risk Adjustment Coder (CRC) certification in an active status, and have endless...RiskHourly payApprenticeshipWork at officeLocal areaRemote workLive inFlexible hoursShift workMonday to Friday
- ...special and impactful. The Opportunity As a dedicated Injury Adjuster, you will work within defined guidelines and framework, responsible... ...What you'll do: Identifies and handles existing and emerging risks that stem from business activities and the job role. Ensures...RiskContract workWork at officeRelocation package3 days per week
- ...Inpatient Facility/HIMS Certified Medical Coder, Quality Associate** position, you bring... ...on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG)... ...DRG (MS/APR-DRG), APC, HCC, other Heath Risk Adjusted Factors, National Correct Coding...RiskWork at officeLocal areaRemote workLive inShift work
- ...organizational process changes. Drive execution of operational risk management, regulatory compliance training, policies and, procedures... ...skills. ~ Acquisition and maintenance of applicable insurance adjuster license within 6 months time in role. What sets you apart...RiskWork at officeRelocation packageH1bFlexible hours
- ...us special and impactful. The Opportunity As a dedicated Auto Adjuster you will proactively handle the complete end to end claims process... ...additional work outside normal duties as needed. Ensures risks associated with business activities are effectively identified,...RiskWork at officeRelocation packageH1bFlexible hoursAfternoon shift3 days per week
- ...Customer Service Auto Claims representative. Your work will focus on adjusting non-injury auto claims and you'll work under supervision to... ...travel with minimal notice during designated CATs. Ensure risks associated with business activities are effectively identified,...RiskWork at officeRelocation packageAfternoon shift2 days per week
- ...special and impactful. The Opportunity As a dedicated Sr Auto Adjuster, you will adjust highly complex auto insurance claims presented... ...additional work outside normal duties as needed. Ensure risks associated with business activities are effectively identified,...RiskContract workWork at officeRelocation packageFlexible hoursAfternoon shift3 days per week
- ...highly skilled support system. Responsibilities - Lead and oversee Medicaid actuarial projects, including rate setting, risk adjustment, and financial modeling. Drive business development efforts, securing new engagements and expanding relationships with existing...Risk
Saenger Associates
Phoenix, AZ16 days ago - ...*Responsibilities** ****CPC or CCS Certification Required** The Coder II reviews and processes complex specialty clinic professional charges... ...of Surgeons). The hospital is also a respected center for high-risk obstetrics neuro-rehabilitation orthopedics and other medical...RiskWork at office
- ...communication and resolve any conflicts. # Problem Solving and Risk Management: Identify potential risks related to structural... ...of the project. Track progress against schedules and make adjustments as necessary to keep the project on track. # Documentation and...RiskContract workFor subcontractorWork at office
Ezarc Solutions
Phoenix, AZ7 days ago - ...Description Job Description Sr. Construction Defect Claims Adjuster Ready to take the next step in your career? Let’s talk about... ...compensation and benefits package. Company Description North American Risk Services (NARS) is a premier third-party claims administrator...RiskWork at officeRemote workWork from home
- ...As a dedicated Auto Adjuster you will proactively handle the complete end to end claims process. Taking statements, policy and coverages... ...surges and catastrophe response operations; and ensuring risks are effectively managed in accordance with policies. Requirements...RiskFull timeWork at officeRelocation packageFlexible hours3 days per week
USAA
Phoenix, AZa month ago - ...The Sr Specialist, Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures the core set of Tier 2 providers in the Health Plan have...RiskWork experience placementWork at officeRemote work
$19.79 - $23.75 per hour
...As a dedicated Sr Auto Adjuster, you will adjust highly complex auto insurance claims presented by or against our members to include the... ...surges and catastrophe response operations, and ensure risks are effectively managed in accordance with policies. Requirements...RiskFull timeContract workWork at officeRelocation packageFlexible hours3 days per weekUSAA
Phoenix, AZa month ago
