Risk Adjustment Coder

3 weeks ago


Cincinnati, United States Staffing Full time
Job DescriptionJob Description

Reviewing patients' medical records to identify diagnoses and procedures performed. Assigning accurate medical codes for diagnoses, treatments, and procedures according to the appropriate classification system. In addition to abstracting diagnosis codes, the Clinical Review Specialist also audits medical records and validates entries that have been submitted to CMS. 

RESPONSIBILITIES: 
•Conducts audits of medical records (paper, EMR, hybrid) 
•Adheres to compliance of Medicare, Medicaid, and Commercial risk adjustment guidelines with precision. 
•Understands, respects, and applies client specific guidelines 
•Adheres to audit and medical record review schedules to meet client expectations and government-regulated deadlines 
•Regularly participates in peer review; provide and receive feedback 
•Ensures accurate documentation to support all audits 
•Assures adherence to and currency with internal and external regulatory guidelines: 
•CMS/HHS 
•DOH 
•HIPAA, HITECH, and Fraud Waste & Abuse 
•Medical coding protocols 
•Maintain coding credentials as required by credentialing agency 

REQUIREMENTS: 
•Coding Certification: CPC, CCS, CRC, RHIT, or RHIA 
•Possess at least 5 years of experience of with ICD-10, CPT and HCPC coding systems 
•Proficiency in MS Office tools such as Word, PPT, Excel and be comfortable learning and becoming an expert on new and proprietary software 

PREFERRED QUALIFICATIONS: 
•Have strong written and verbal communication skills, including propensity to establish and build strong relationships. 
•Take initiative to establish priorities, coordinate work activities and perform multiple and complex tasks while working independently and with minimal supervision in a remote setting. 
•Ability to consistently meet established minimum quality standards in a heavy production environment 
•Must be able to meet organization production and accuracy goals 
•CRC Certification  4+ month Contract 100% Remote,Mini 30 hours in a week including weekends. pay $28.00 with Flexible hours including weekend.



  • Cincinnati, United States Hueman Risk Adjustment Full time

    Job DescriptionJob DescriptionHueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Cincinnati, OH. This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule designed with...


  • Cincinnati, United States Hueman Risk Adjustment Full time

    Job DescriptionJob DescriptionHueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Cincinnati, OH. This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule designed with...

  • Benefits Analyst

    3 weeks ago


    Cincinnati, United States Risk Strategies Full time

    The Benefit Analyst assists in all aspects of day-to-day client management as directed by members of the team. The Benefit Analyst supports client teams in developing benefit strategies and meeting client goals and objectives and in selecting programs that best meet the client's needs and financial requirements. The essential functions include data analysis,...

  • Hcc Coder

    1 week ago


    Cincinnati, United States Bon Secours Mercy Health Full time

    At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Primary Function/General Purpose of Position** **Essential Job Functions** - Reviews ambulatory encounters in the electronic medical...


  • Cincinnati, Ohio, United States AIG Full time

    Who we are American International Group, Inc. (AIG) is a leading global insurance organization. AIG member companies provide a wide range of property casualty insurance in approximately 70 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets and manage risks. Were also...


  • Cincinnati, United States Deloitte Full time

    Position Summary Data Privacy Manager Passionate about making a real difference in the world of data privacy? Eager to transform and fortify the privacy strategies of some of the globe's most dynamic organizations using cutting-edge technology? Imagine doing so while simultaneously boosting your career in Deloitte & Touche LLP’s innovative...


  • Cincinnati, Ohio, United States CLevelCrossing Full time

    Humana is a $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a...

  • Internal Auditor

    5 days ago


    Cincinnati, United States GE Renewable Energy Power and Aviation Full time

    Job Description SummaryA key dimension of this role will be to coordinate with the Audit Manager and other team members to execute the audit process, including risk assessment, audit execution and reporting results for GE Aerospace including:• Collaborating with the Manager and other audit team members to identify and evaluate risks• Identifying systemic...


  • Cincinnati, United States TruPartner Credit Union Full time

    POSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will include evaluating...


  • Cincinnati, United States TruPartner Credit Union Full time

    Job DescriptionJob DescriptionPOSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will...


  • Cincinnati, United States TruPartner Credit Union Full time

    POSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will include evaluating...


  • Cincinnati, United States TruPartner Credit Union Full time

    POSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will include evaluating...


  • Cincinnati, United States TruPartner Credit Union Full time

    POSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will include evaluating...

  • Quantitative Analyst I

    13 hours ago


    Cincinnati, United States Fifth Third Full time

    Make banking a Fifth Third better We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: The Quantitative Analyst I will provide support for the development, implementation, and documentation of innovative fraud prevention strategies by analyzing fraud trend...


  • Cincinnati, United States TruPartner Credit Union Full time

    Join our dynamic risk management team as a Fraud and Dispute Analyst! In this pivotal role, you'll be at the forefront of safeguarding our credit union against fraudulent activities while ensuring seamless member experiences. Here's what you'll be doing: Reviews online account requests and makes decisions on applications sent to manual review. Monitors...


  • Cincinnati, United States TruPartner Credit Union Full time

    Job DescriptionJob DescriptionJoin our dynamic risk management team as a Fraud and Dispute Analyst! In this pivotal role, you'll be at the forefront of safeguarding our credit union against fraudulent activities while ensuring seamless member experiences. Here's what you'll be doing:Reviews online account requests and makes decisions on...


  • Cincinnati, United States TruPartner Credit Union Full time

    POSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will include evaluating...


  • Cincinnati, United States TruPartner Credit Union Full time

    POSITION DETAILApproaching $200M in assets, TruPartner Credit Union, located in Cincinnati, OH is currently in search of a proven lending executive to serve as its Vice President of Lending. Reporting directly to the Chief Executive Officer, this individual will oversee all lending and loan participations. Responsibilities will include evaluating...

  • Director Of Safety

    4 weeks ago


    Cincinnati, United States Actalent Full time

    Description: Position Overview: Oversees the entire safety program developing an inherent culture which makes safety the most important task we face each day. Works to prevent workplace accidents and promotes health and safety awareness and education to fellow employees. Responsible for making sure that employees follow health and safety laws and creating...

  • Director Of Safety

    1 month ago


    Cincinnati, United States Actalent Full time

    Description: Position Overview: Oversees the entire safety program developing an inherent culture which makes safety the most important task we face each day. Works to prevent workplace accidents and promotes health and safety awareness and education to fellow employees. Responsible for making sure that employees follow health and safety laws and creating...