EM guidelines mandatory. Thorough knowledge of Official Coding Guidelines Strong knowledge of HCC/risk-adjustment documentation... required: Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT...
set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Clinical Coding Nurse Consultant will drive Risk... Adjustment improvement initiatives, develop recommendations for Risk Adjustment remediation plans and create tools and databases...
organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition... of audits to management, clinicians, and committees as appropriate. Reports areas of risk directly to the Coding Integrity...
organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition... of audits to management, clinicians, and committees as appropriate. Reports areas of risk directly to the Coding Integrity...
) required and Certified Coding Specialist (CCS) or (CRC) Certified Risk Adjustment Coder or Registered Health Information Technician (RHIT... CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required 2 years...
) or coding (RHIA, RHIT, CPC, CRC, CCS) required. 1 or more years' experience in HCC/Risk Adjustment preferred. Knowledge of ICD...GENERAL SUMMARY: The Outpatient Clinical Documentation Specialist (CDS), in conjunction with physicians, coders...
a Certified Risk Adjustment Coder Certification (CRC) within eighteen (18) months of hire. Must obtain certified Clinical... environment, this Outpatient Clinical Documentation Specialist (CDS) position uses the clinical/nursing knowledge...
Documentation Specialist 3 serves as a key resource for CDI/Coding/Quality, and works in collaboration with CDI & quality leadership... star rating, Vizient, and US News and World Report risk-adjustment systems to identify clinical documentation improvement...
, risk adjustment, accurate coding, accuracy of patient outcomes, and complexity of patient care. This includes accurate... coding experience required; or a combination of 1-2 years coding experience and HCC Capture, Risk Adjustment or Outpatient...
Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding...), Certified Coding Specialist (CCS), Certified Inpatient Coder(CIC), or Certified Clinical Documentation Specialist (CCDS...
and apply coding concepts. Knowledge of risk adjustment methodologies and HCC documentation requirements. Strong organizational... adjustment coding accuracy and completeness. Ensure proper documentation of Hierarchical Condition Categories (HCCs...
Administrator (RHIA), Registered Nurse (RN), Registered Respiratory Therapist, Certified Coding Specialist (CCS), or Certified... Coding Specialist-Physician-based (CCS-P), or International or Domestic Medical Degree also required. MUST HAVE: Experience...
Administrator (RHIA), Registered Nurse (RN), Registered Respiratory Therapist, Certified Coding Specialist (CCS), or Certified... Coding Specialist-Physician-based (CCS-P), or International or Domestic Medical Degree also required. MUST HAVE: Experience...
Specialist (CCS), Certified Risk Adjustment Coding (CRC) or Certified Professional Coder (CPC) required. RN Licensure preferred... collection and analysis of risk adjustment data in-order to identify documentation, coding trends and opportunities Audit...
; risk adjustment scores; prevalence rates; Unit Cost Reduction Trend) to determine which programs to implement and/or modify...; geographic coverage) to determine potential network gaps in care and risk adjustment indicator opportunities Implement new rates...
; risk adjustment scores; prevalence rates; Unit Cost Reduction Trend) to determine which programs to implement and/or modify...; geographic coverage) to determine potential network gaps in care and risk adjustment indicator opportunities Implement new rates...
of risk adjustment methodologies and clinical documentation standards. Working knowledge of utilization review and post-acute... to 5pm Potential HYBRID position after 90 days! Job Summary: The Clinical Documentation and Utilization Review Specialist...
Billing Specialist will review charges submitted and process claims for payment and application of the sliding fee schedule.... This includes resolving internal claim edits to ensure claims are submitted cleanly including adjustment claims, correction...
Medical Record Retrieval Specialist Supports the company’s risk adjustment projects by collaborating with vendors... and provider offices/facilities to retrieve medical records. Supports other initiatives related to Risk Adjustment Programs (RAPS...
This position is part of the UW support career progression and may report to a Senior Specialist, UW Support, Team... Support Unit of the unit’s field operations. This role assists the underwriters by screening risk offerings and with pre...