- Fallon Health (Worcester, MA)
- …of the Risk Adjustment Analyst (RAA) will be to function as the Claims SME for the Risk Adjustment & Analytics Department. The RAAimplements data ... risk outcome improvement. The RAA will own the claims adjustment workflow associated with regulatory retrospective...Working knowledge of the provider-based healthcare industry, claims processing, provider billing or Risk … more
- The Cigna Group (Bloomfield, CT)
- …if do not live near a Cigna Office]** We have an immediate need to strengthen our Risk Adjustment and Stars Enablement team. The Risk Adjustment and ... is responsible for developing solution changes for the ongoing needs of CMS Medicare Risk Adjustment processes and systems. The **Medicare Risk Adjustment… more
- VNS Health (Manhattan, NY)
- …Education: + Associate's degree in nursing required Work Experience: + Minimum five years of claims coding and risk adjustment experience in a Medicare or ... OverviewAs the Clinical Manager for Risk Adjustment , you will be at...wellness programs + Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care + Generous tuition reimbursement for… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, HHS- Risk ... and documentation guidelines. The development and ongoing maintenance of the Commercial Risk Adjustment Coding guidelines, as well as, guiding junior coding… more
- UCLA Health (Los Angeles, CA)
- …+ A Certified Professional Coder (CPC) certification and a Certified Risk Adjustment Coder (CRC), required + Bachelor's degree ( healthcare or relevant field) ... Description As the Medicare Advantage Risk Adjustment Provider Documentation Trainer and...NCQA technical specifications, required + Knowledge of Medicare Advantage billing/ claims submission and other related actions, preferred + Knowledge… more
- Banner Health (Phoenix, AZ)
- …and develops clinical strategies and educational initiatives around the impact that accurate risk adjustment has on the performance of our MA, MSSP, Medicaid, ... care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal...as the clinical DYAD to the Executive Director of Risk Adjustment , co-leading a robust team that… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST** **Location:** Trinity Health PACE Corp Michigan ... to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data...+ Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not… more
- Elevance Health (Indianapolis, IN)
- ** Risk Adjustment Data Reporting Analyst** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 ... our Elevance Health Pulse Point locations. **Preferred Location:** Indianapolis, IN. The ** Risk Adjustment Data Reporting Analyst** is responsible for analyzing,… more
- Walgreens (Deerfield, IL)
- …attorneys. **Job Responsibilities** + Reviews, analyzes and evaluates the investigation, adjustment and reserving for moderately complex Liability claims . ... is included in the US Retail Pharmacy and US Healthcare segments of Walgreens Boots Alliance, Inc. (Nasdaq: WBA),...handling Liability claims . + Knowledge of Liability claims and 3rd party claim management systems; risk… more
- Molina Healthcare (Richmond, KY)
- **Job Description** **Job Summary** The Sr Analyst, Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics ... with research, development,and completion of special projects. **Knowledge/Skills/Abilities** + Assist Risk Adjustment Data Analytics Leaders in Prospective and… more