risk adjustment representative

JOB SUMMARY:The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program...

Risk Adjustment Campaign Associate Hybrid role (3 days/week in office) at our Portland, Medford, Burlington, Vancouver, Renton, Boise, Lewiston, Spokane or Salt Lake City offices. Candidates must reside within commutable distance of that location. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable...

Primary Purpose:Support the risk and quality team, IPA Administrators, and the VP of Operations on Clinical Initiatives to improve patient outcomes and group quality measures in Risk Adjustment, CMS 5 Star, and the commercial and Medi-Cal programs.Principal Duties and Responsibilities (* = essential functions):Outreach and coordinate care for IPA members who...

Mass Advantage is a Medicare Advantage health plan, located in the heart of Worcester County, headquartered in Worcester MA. Mass Advantage is owned and designed by UMass Memorial Health providers with their patients’ needs in mind.We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This...

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves...

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves...

Location: Birmingham, Alabama Job Summary The Risk Adjustment Specialist ensures all ICD-10 codes are documented for the assignment of valid and accurate HCCs for each record reviewed for submission to the Centers for Medicare & Medicaid Services (CMS). Other responsibilities include working suspect reports to identify unreported diagnosis codes and...

Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans. Key Details: Ideal candidate to live in the state of PA. • Develop and implement action plans, across all departments affecting assigned products and plans, to address issues identified by the business...

Job Description Risk Adjustment Coder Location: Baton Rouge, LA 70809Contract Length: 4 Months Position Summary We are seeking an experienced Risk Adjustment Coder with a strong background in Medicare Advantage Risk Adjustment and ACA Risk Adjustment coding. This position supports ongoing risk adjustment initiatives through accurate coding, medical record...

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.What you do at McKesson matters. We foster a...

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves...

Be part of our growing regional company whose main objective is putting our patients first. The provider educator is responsible for identifying opportunities to improve coding, documentation and quality of care. The educator will customize an education plan customized for each provider.Position overview: Plan, conduct and coordinate all aspects of MRA...

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves...

It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:OverviewPerforms compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV)...

JOB SUMMARY:The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program...

There’s no place like Liberty Healthcare Management Come explore career opportunities with Liberty Healthcare Management, a dynamic leader in the healthcare industry. Join us! We are currently seeking an experienced: RISK ADJUSTMENT CODER (MUST RESIDE IN NC) Job Summary: Perform code abstraction of medical records to ensure ICD-10-CM codes are...

Job DescriptionJob DescriptionHi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for...

Title: Risk Adjustment ConsultantHours: 40 hours per week; M-F.Location: Fully RemoteJob OverviewUnder the director of the Director, Risk Adjustment Operations,  performs accurate and timely reviews and validations of Medicare, Medicaid, Commercial HCCs and DxCG’s through medical record reviews. Reviews provider documentation for ICD-10-CM codes to verify...

JOB SUMMARY: The Risk Adjustment Analyst II supports the organization’s Medicare Advantage (MA) and Affordable Care Act (ACA) risk adjustment programs by managing data submissions, developing reporting, and delivering actionable analytics. This role is responsible for ensuring the accuracy and integrity of encounter and risk score data, including RAF (MA)...