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$75k - $85k
Overview We are currently seeking a highly motivated Risk Adjustment Coding Specialist II. This role will report to a Sr. Manager - Risk Adjustment... ...through informal discussion and overread assignments; support coder training and orientation as requested by manager May assist or...RiskWork at officeMonday to Friday$75k - $85k
Risk Adjustment Coding Specialist II (Central Maryland) Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1668 S. Garfield... ...informal discussion and overread assignments. Supports coder training and orientation as requested by manager. May assist or...RiskFull timeWork at officeMonday to Friday$71.3k - $82.6k
...outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance... ...appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure...RiskFull timeWork experience placement- ...Industry: Healthcare Services Why consider this job opportunity: - Opportunity for career advancement and leadership in national risk adjustment studies - Competitive benefits and compensation package - Analyze and synthesize data to make a significant impact on Medicaid...RiskRemote jobImmediate start
- ...Industry: Healthcare Services Why consider this job opportunity: - Opportunity for career advancement and leadership in national risk adjustment studies - Competitive benefits and compensation package - Engage with data analysis to drive improvements in Medicaid risk...RiskRemote jobImmediate start
- Job Description Job Summary The Analyst, Risk Adjustment-Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics team. Designs and develops Suspect, Targeting, and Tracking System to support Molina’s Prospective and Retrospective Interventions...RiskWork at office
$103.5k - $127.4k
...Liability Claims Adjuster The Liability Claims Adjuster plays a critical role in our risk management process by conducting thorough investigations of all third-party claims while providing an exceptional customer service experience. This role will be tasked with gathering...RiskFull timeLocal area- ...accurately to maintain compliance, and minimize risk and denials. Contributes to overarching... ...to provider network regarding risk adjustment and coding updates related to risk adjustment... ...and experience. Certified Professional Coder (CPC). Certified Coding Specialist (CCS)....RiskWork at office
$86k - $172k
Yamaha has an excellent opportunity for a Risk Manager II to join our Financial Services team in Cypress, CA . The Risk Manager II... ...risk initiatives like scorecard development, strategy design and adjustments. Perform quantitative analysis and monitor company's credit,...RiskHourly payTemporary workWork experience placementLocal area- PURPOSE To support the Risk Management department in the timely and accurate handling of workplace injury claims by maintaining organized... ...-to-work plans. Support communication with third-party claims adjusters and internal teams. Ensure all information is handled...RiskPermanent employmentWork at officeShift workNight shift
$79.04k - $126.88k
...ERM Data Analyst assists in the execution of F&M’s Enterprise Risk Management (ERM) data management goals. This role emphasizes data... ...calibration of Verafin FRAML models by recommending parameters adjustments backed by statistical evidence. Document tuning rationale and...RiskFull timeContract workImmediate start$89.9k - $160.6k
...financial modeling tools, spreadsheets and information acquisition tools Experience with provider capitation, both diagnostic risk-adjustment and age/sex adjusted rate banding Experience in interpreting and reviewing financial modeling results to evaluate financial impact...RiskRemote jobMinimum wageFull timeContract workWork experience placementLocal area- ..., equipment, and budget, to support project initiatives. Monitor resource utilization and make adjustments as needed to optimize project efficiency and effectiveness. Risk Management: Identify potential risks and issues that may impact project delivery and develop mitigation...RiskFull time
InterDent Service Corporation
El Segundo, CA24 days ago $45k - $60k
...the claims process, providing guidance and facilitating communication between clients and claims adjusters. - Monitor and follow up on claims to ensure timely resolution. Risk Management: - Identify potential risks and provide risk management advice to clients. - Conduct...RiskWork experience placementWork at officeMonday to Friday- ...and monitoring submitted codes on claim/encounters for Medicare Risk Adjustment. How will you make an impact & Requirements Location:... ...setting or large group practice. Current Certified Professional Coder certification (CPC, CPC-H, CCS, or CCS-P) required. Additional...RiskFull timeWork from home2 days per week3 days per week
$90.16k - $112.7k
...and monitor submitted codes on claims/encounters for Medicare Risk Adjustment. Location & Work Arrangement Location: Must reside in Los Angeles... ...large group practice setting. Current Certified Professional Coder (CPC, CPC-H, CCS, or CCS-P) certification required. Experience...RiskFull timeWork from home2 days per week- ...outcomes and assign follow-ups to ensure technical alignment and risk mitigation. Issue Resolution: Maintain a live project issue... ...consistent, data-driven updates to executive and technical stakeholders; adjust strategies and timelines as needed based on risk and performance...RiskRemote work
Totex Manufacturing Inc
Torrance, CAa month ago $137.5k - $195k
...s largest providers of traditional and nontraditional solutions for companies that need financing and investors who seek strong risk-adjusted returns. Since 1971, our people have shaped our organization through a high-performance inclusive culture, in which we celebrate...RiskFull timeWorldwideFlexible hoursPIMCO
Newport Beach, CA15 days ago$100k - $120k
...General Manager to perform all-purpose duties, which may include, but is not limited to the overall operation of their center, including risk management, teammate development, client metrics, production, and administration. This individual will also recruit, recognize, and...RiskWeekly payFull timeLocal areaImmediate startCaliber Collision
Cerritos, CA3 days ago- Overview Job Description Job Summary The AVP, Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and Quality for all lines of business, ensuring alignment of strategy and activities with Enterprise, acting as the Risk Adjustment...RiskContract workLocal areaImmediate start
$110.2k - $188.8k
...work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities Lead the end-to-end risk adjustment strategy and execution, including data capture, gap closure, and CMS submission processes, ensuring accuracy, compliance, and...RiskRemote jobMinimum wageFull timeWork experience placementLocal area$90.16k - $112.7k
...and monitoring submitted codes on claim/encounters for Medicare Risk Adjustment. How will you make an impact & Requirements Location:... ...large group practice setting. Current Certified Professional Coder certification (CPC, CPC-H, CCS, or CCS-P) required. Additional...RiskFull timeWork from home2 days per week3 days per week- ...Commercial GL Claim Adjuster Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North... ...vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the...RiskTemporary work
$103.5k - $133.9k
...Provide technical support for cost control (specifically with the risk and opportunity log). Assist with specific sections of the... ...vision, peripheral vision, depth perception, and the ability to adjust focus. Employee views computer monitor frequently. The employee...RiskContract workFor contractorsApprenticeshipInternshipWork at officeWeekend workThe Boldt Company
Whittier, CA3 days ago$90k - $130k
...and key milestones. Proactively monitor project progress and adjust timelines as needed to address delays or conflicts. Lead regular... ...implementing corrective actions where necessary. Safety & Risk Management Ensure all field operations and project activities...RiskFull timeFor contractorsWork at officeLocal areaPacific Industrial Electric
Brea, CA4 days ago$70k - $80k
Workers Compensation Claims Adjuster | Dedicated Account | Hybrid - Orange, CA By joining Sedgwick, you'll be part of something truly meaningful... ..., Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring countsSM; the...RiskContract workWork at officeLocal areaFlexible hours- ...Friday. Job Summary This position works very closely with the Risk Manager & the VP of HR. This position supports Risk Management... .... Be a liaison between injured employees and insurance adjusters, to ensure employees are taken care of. -High level of confidentiality...RiskMonday to Friday
Barker Management Inc
Anaheim, CA14 days ago - ...National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-... ...Your Role on the Team Position Summary: The Lead Outpatient Coder codes and abstracts data elements from patient records according...RiskMonday to Friday
- ...Coordinates resolution of physician issues, working with Director, risk management, patient safety, system legal, and medical staff... ...experiencing major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes,...RiskFull timeWork experience placementFlexible hours
- ...Design scalable workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity. Technology... ...change management (training, SOPs, job aids, communications). Risk, Compliance & Quality: Ensure alignment to CMS, HIPAA, state regulations...Risk
