Risk Adjustment Coder
Found in: Lensa US P 2 C2 - 1 week ago
SUMMARY: Risk Adjustment Coder is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment requirements. Reports to: AVP, STARs & Risk Adjustment Location: Houston, TX EDUCATION: • High School Diploma or GED Required LICENSES/CERTIFICATIONS: A certification in one of the following is required: • Certified Risk Adjustment Coder (CRC) • Certified Professional Coder (CPC) • Certified Coding Specialist (CCS) EXPERIENCE: • Minimum of three (3) years HCC experience performing retrospective risk adjustment chart review required. • Minimum of three (3) years of experience in a hospital, a physician setting or a Managed Care Organization as a medical coder. • Minimum of five (5) years ICD-9 CM/ ICD-10 CM coding experience required. • Current AAPC or AHIMA credential required. • Managed Care Experience preferred. • Knowledge of Medicare Risk Adjustment required. SKILLS: • Knowledge of healthcare delivery • Strong oral and written communication skills. • Ability to work in a fast-paced environment with changing priorities. • Ability to work with others in a matrixed environment. • Demonstrated written communication skills. • Demonstrated time management and priority setting skills. • Demonstrated problem solving skills. • Demonstrated organizational skills. RESPONSIBILITIES: • Follows CMS Risk Adjustment guidelines and has a complete understanding of these guidelines. • Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission. • Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD10-CM coding classification systems. • Selects and accurately records all appropriate records and data on assigned chart abstraction projects. • Ability to meet productivity and accuracy standards. • Tracking and monitoring of medical records requests for all risk adjustment projects. • Performs telephonic outreach to provider practices and/or facilities to request medical records. • Performs other duties as assigned. TECHNICAL SKILLS: • Working knowledge of Microsoft Office • Working knowledge of Electronic Health Records (EHR) ABOUT APEX HEALTH SOLUTIONS Apex Health Solutions powers payers and providers choosing to engage in value-based risk contracting. Apex’s unique solutions create alignment between payers and providers, generating unparalleled value. Combined with Apex’s experienced and successful industry leadership, our focal point remains on improvement in patient quality, satisfaction and overall cost of care.
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Risk Adjustment Coder
2 weeks ago
Houston, United States Apex Health Solutions Full timeJob DescriptionJob DescriptionSUMMARY:Risk Adjustment Coder is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment requirements.Reports to: AVP, STARs & Risk AdjustmentLocation: Houston, TXEDUCATION:• High School Diploma or GED...
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Coding Quality Assur Spec III
Found in: Talent US C2 - 2 weeks ago
Houston, United States Texas Children's Hospital Full timeWe’re looking for a Coding Quality Assurance Specialist III, someone who’s ready to grow with our company. In this position you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory...
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Power Trading Risk Manager
2 days ago
Houston, United States Selby Jennings Full timePosition Overview: Selby Jennings is partnered with a national renewable energy commodity shop to source talent for a Power Trading Risk Manager. The Power Trading Risk Manager will play a pivotal role in implementing a risk framework through quantitative analysis. This individual will ensure that new commercial strategies align with portfolio performance...
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Power Trading Risk Manager
Found in: Appcast Linkedin GBL C2 - 3 days ago
Houston, United States Selby Jennings Full timePosition Overview: Selby Jennings is partnered with a national renewable energy commodity shop to source talent for a Power Trading Risk Manager. The Power Trading Risk Manager will play a pivotal role in implementing a risk framework through quantitative analysis. This individual will ensure that new commercial strategies align with portfolio performance...
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Medical Billing Coder
1 week ago
Houston, United States North American Consultants Inc Full timeJob DescriptionJob DescriptionWe are currently looking to hire a self-starter and detail oriented individual to assist with reading comprehension of medical and billing reports to generate, edit, and compile controverting affidavits for filing.The ideal candidate will have a keen eye for detail and the ability to work well in a fast-paced environment. We are...
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Director of Professional Revenue Integrity
1 week ago
Houston, United States CareerBuilder Full timeJob Profile Summary This position is responsible for overseeing and managing all aspects of professional service charges to secure the organizations revenue integrity. The Director, Professional Revenue Integrity is accountable for the execution of the leadership, development, vision, operational and fiscal management of the professional services revenue...
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Director of Professional Revenue Integrity
Found in: Appcast Linkedin GBL C2 - 2 weeks ago
Houston, United States Insight Global Full timeJob Profile Summary This position is responsible for overseeing and managing all aspects of professional service charges to secure the organization’s revenue integrity. The Director, Professional Revenue Integrity is accountable for the execution of the leadership, development, vision, operational and fiscal management of the professional services revenue...
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Toxic Tort Claims Manager
2 weeks ago
Houston, United States NOV Inc. Full timeThe Claims Manager will support different functions at the corporate risk management level as directed by the VP Risk Management. The Claims Manager will oversee and manage all auto liability, general liability and workers compensation claims that are handled by Third Party Administrators (TPA) and various insurers. **Job Duties** - Provide management...
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Natural Gas Trading Analyst
1 week ago
Houston, United States Selby Jennings Full timeNatural Gas Trading AnalystWe are partnered with one of, if not the largest national utility companies who is seeking a talented and analytical Natural Gas Analyst to join their team. The ideal candidate will have a strong background in energy markets, particularly natural gas, and possess exceptional quantitative and qualitative analysis skills. This role...
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Natural Gas Trading Analyst
Found in: Appcast US C2 - 1 week ago
Houston, United States Selby Jennings Full timeNatural Gas Trading AnalystWe are partnered with one of, if not the largest national utility companies who is seeking a talented and analytical Natural Gas Analyst to join their team. The ideal candidate will have a strong background in energy markets, particularly natural gas, and possess exceptional quantitative and qualitative analysis skills. This role...
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Natural Gas Trading Analyst
Found in: Appcast Linkedin GBL C2 - 2 weeks ago
Houston, United States Selby Jennings Full timeNatural Gas Trading AnalystWe are partnered with one of, if not the largest national utility companies who is seeking a talented and analytical Natural Gas Analyst to join their team. The ideal candidate will have a strong background in energy markets, particularly natural gas, and possess exceptional quantitative and qualitative analysis skills. This role...
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Toxic Tort Claims Manager
Found in: Talent US 2 C2 - 6 days ago
Houston, United States NOV Full timeJOB DESCRIPTIONThe Claims Manager will support different functions at the corporate risk management level as directed by the VP Risk Management. The Claims Manager will oversee and manage all auto liability, general liability and workers compensation claims that are handled by Third Party Administrators (TPA) and various insurers. Job Duties• Provide...
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Environmental Claims Specialist
Found in: Talent US 2 C2 - 6 days ago
Houston, United States NOV Full timeJOB DESCRIPTIONThe Claims Manager will support different functions at the corporate risk management level as directed by the VP Risk Management. The Claims Manager will oversee and manage all auto liability, general liability and workers compensation claims that are handled by Third Party Administrators (TPA) and various insurers. Job Duties• Provide...
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Project Manager
4 days ago
Houston, United States Loan Factory Full timeTX-Houston **Summary** **Responsibilities** - ** Project Planning: Develop comprehensive project plans, including scope definition, timelines, resource allocation, and budget management.** - ** Team Leadership: Guide and motivate cross-functional teams, assigning tasks, providing clear direction, and fostering a collaborative environment.** - ** Risk...
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Internal Controls Manager
7 days ago
Houston, United States NorthPoint Search Group Inc Full timeInternal Controls Manager – $120k - $140k + 20% bonus Our growing client has an immediate need for an Internal Controls Manager. The ideal candidate will have eight or more years of Internal Audit experience and a CPA or CIA. Duties: Developing and implementing robust internal control policies, procedures, and guidelines to mitigate risks and ensure...
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Front Desk Receptionist Pitner Clinic
7 days ago
Houston, United States Spring Branch Community Health Center Full time**SUMMARY:** The **Front Desk Support/Receptionist** works as part of the medical office team performing necessary clerical duties to prepare patients for the Check In/Out, Registration, Eligibility and Scheduling process. Also responsible for answering telephones and gathering third party payment information, recording charges, and collecting payments....
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Internal Medicine Full-Time position in Houston, Texas
Found in: beBee S US - 2 weeks ago
Houston, United States Optum Full time**Opportunities at WellMed,** part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you...
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Senior Associate
Found in: Talent US A C2 - 7 days ago
Houston, United States Brookfield Asset Management, Inc Full timeLocation Two Allen Center - 1200 Smith Street Business - Reinsurance Brookfield's publicly traded Reinsurance business, Brookfield Reinsurance Partners Ltd., is a newly formed division of Brookfield focused on providing capital-based solutions to insurance companies and their stakeholders. Brookfield Reinsurance is positioned to act as a strong,...
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Internal Medicine Full-Time position in Houston, Texas
Found in: beBee jobs US - 1 week ago
Houston, Texas, United States Optum Full timeOpportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you...
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Technical Project Manager Iii
6 days ago
Houston, United States JPMorgan Chase & Co Full time**JOB DESCRIPTION** Join our dynamic team to innovate and drive technology advancements, contributing to significant business growth and client success. **Job responsibilities** - Develop and execute comprehensive project plans, incorporating technical requirements, resource allocation, and timelines to ensure timely and successful delivery of technology...