Current jobs related to Risk Adjustment Coder - Long Beach - Advanced Medical Manage

  • Risk Adjustment Coding Specialist

    1 month ago

    Long Beach, California, United States Advanced Medical Manage Full time

    Job Title: Risk Adjustment CoderAt Advanced Medical Manage, we are seeking a highly skilled Risk Adjustment Coder to join our team.Job SummaryThe Risk Adjustment Coder will be responsible for ensuring accurate and compliant coding of medical records to meet Risk Adjustment guidelines. This role requires strong analytical and problem-solving skills, as well...

  • Risk Adjustment Coding Specialist

    4 weeks ago

    Long Beach, California, United States Advanced Medical Manage Full time

    Job Description**Job Summary**The Risk Adjustment Coding Specialist is responsible for managing and training on Risk Adjustment HCC coding to ensure effective collaboration between physicians, office staff, and health plan representatives to achieve goals.**Key Responsibilities**Review medical records to identify, collect, assess, monitor, and document...

  • Risk Adjustment Consultant

    1 week ago

    Long Beach, California, United States Blue Shield of California Full time

    Your RoleThe Risk Adjustment Consulting team at Blue Shield of California is seeking a highly skilled and experienced professional to join our team as a Risk Adjustment Consultant. In this role, you will lead the Member Incentive Program and support the In-Home Visit program within the Risk Adjustment team.Your WorkAs a Risk Adjustment Consultant, you will...

  • Risk Adjustment Consultant

    3 weeks ago

    Long Beach, California, United States Blue Shield of California Full time

    About the RoleWe are seeking a highly skilled Risk Adjustment Consulting, Consultant to join our team at Blue Shield of California. As a key member of our Risk Adjustment Prospective Program team, you will play a critical role in transforming healthcare by making it more accessible, affordable, and customer-centric.Key ResponsibilitiesLead the Member...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your RoleThe Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    2 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your Role The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    2 weeks ago

    Long Beach, CA, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, CA, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    2 weeks ago

    Long Beach, CA, United States Blue Shield of California Full time

    Your Role The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • Risk Adjustment Consulting, Consultant

    3 weeks ago

    Long Beach, CA, United States Blue Shield of California Full time

    Your Role   The Risk Adjustment Prospective Program team focused on transforming health care by making it more accessible, affordable and customer-centric. The Risk Adjustment Consulting, Consultant will report to the Senior Manager of Risk Adjustment. In this role you will lead the Member Incentive Program while supporting the In-Home Visit program (IHV)...

  • HCC Coding Specialist

    2 months ago

    Long Beach, California, United States Advanced Medical Manage Full time

    Job OverviewPOSITION SUMMARYThe HCC Coding Specialist plays a crucial role in managing and training for Risk Adjustment HCC coding, ensuring seamless collaboration among healthcare providers, office personnel, and health plan representatives to meet organizational objectives.KEY RESPONSIBILITIESAnalyze medical records to identify, gather, evaluate, and...

  • Nurse Practitioner Opportunities in Myrtle Beach

    2 weeks ago

    Myrtle Beach, South Carolina, United States Hueman Risk Adjustment Solutions Full time

    Hueman Risk Adjustment Solutions is seeking a skilled Nurse Practitioner to join our team in completing in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in the Myrtle Beach area. This unique opportunity offers flexibility and autonomy, allowing you to work on your own terms while enjoying a schedule designed with your preferences in...

  • Insurance Claims Adjuster

    6 days ago

    North Myrtle Beach, South Carolina, United States Davies Risk Services Full time

    Seeking Independent Contractors to Perform Insurance Property InspectionsDavies Risk Services is looking for independent contractors to perform insurance property inspections.This is a great opportunity for supplemental income or full-time work. You determine your hours and volume.Our contractors survey both residential and commercial properties.The survey...

  • Claims Adjuster

    5 days ago

    Virginia Beach, Virginia, United States Sedgwick Full time

    Role SummarySedgwick is seeking a Claims Adjuster to analyze and process low to mid-level auto and transportation claims. As a Claims Adjuster, you will assess damage, make payments, and ensure claim files are properly documented and correctly coded based on the policy.Key ResponsibilitiesProcess auto property damage and lower level injury claimsDevelop and...

  • Property Claims Adjuster

    7 days ago

    juno beach, United States IntePros Full time

    About the Company - IntePros is seeking a Senior Property Claims Adjuster who will be able to investigate, evaluate, and manage to resolution assigned Property claims of varying monetary exposures and/or complexity. This position will require both direct claim handling and Third-Party Administrator (“TPA”) oversight and supervision. The position will...

Risk Adjustment Coder

3 months ago

Long Beach, United States Advanced Medical Manage Full time
Job DescriptionJob Description

POSITION SUMMARY

The Risk Adjustment Coding Specialist is responsible for Risk Adjustment HCC coding management and training both internally and externally to ensure that physicians, office staff and health plan representatives are working together effectively to achieve goals.

RESPONSIBILITIES-DUTIES

  • Review medical record information to identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Audit provider documentation of CPT, ICD-9 and ICD-10 codes to ensure adherence with coding and CMS Risk Adjustment guidelines
  • Evaluate HCC auditing processes and provide analyses and recommendations to improve overall provider documentation and coding
  • Responsible for ongoing provider education on HCC
  • Support and participate in process and quality improvement initiatives
  • Meet productivity and quality standards
  • Review Comprehensive Annual Wellness Examination (CAPE) forms
  • Performs other duties, as required

EDUCATION & EXPERIENCE REQUIREMENTS

  • Bilingual proficiency in Korean preferred but not required
  • Minimum 2 years HCC coding experience required
  • Certified Medical Coder with either CPC or CCS
  • Knowledge of Medicare managed care
  • Cultivate positive professional and interpersonal relationships with providers and IPA
  • Excellent verbal and written communication skills
  • Effective organizational skills
  • Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information
  • Ability to work both independently and as part of a team
  • Must be able to achieve and maintain an accuracy standard of 95% and better
  • Knowledge of Outlook, Word, Excel and PowerPoint
  • EMR experience
  • Must possess a reliable vehicle and clean and unrestricted CA driver’s license
  • Must be able to travel