- The Cigna Group (Bloomfield, CT)
- …Experience with HCC coding (required). + Extensive knowledge of CMS guidance of Risk Adjustment & ICD-10 CM diagnosis guidelines (required). + Extensive ... high level of quality, as set by internal standards, to ensure continued auditor accuracy. + Stays up-to-date with current Cigna Medicare coding guidelines. +… more
- Providence (OR)
- …the best people, we must empower them._** **Providence Health Plan is calling an** HCC Risk Adjustment QA Auditor : Medicare Advantage & ACA **who will:** + ... Perform internal coding audits of Hhierarchical Condition category (HCC) coding review for Risk Adjustment staff, contractors, and vendors + Perform audits to… more
- UPMC (Pittsburgh, PA)
- …with DRG Assignment and clinical validation of diagnoses. + Experience with HCC/ Risk Adjustment coding preferred. + Proficiency using Epic, One Content ... UPMC Health Plan is looking for an Intermediate Clinical Auditor /Analyst to join the Quality Assurance team! This role...however, this role may work remotely. The Intermediate Clinical Auditor /Analyst is an integral part of the Quality Assurance… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Reviews CDI quality liaison recommendations as it relates to mortality, PSI/HAC, POA and risk adjustment codes and makes changes as needed in compliance with ... as a leader of positive change. The **Diagnosis Related Group (DRG) Auditor ** is responsible for auditing clinical documentation that supports code assignment for… more
- Molina Healthcare (NM)
- …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and ... (RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… more
- SSM Health (MO)
- …scoring. + Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings. + Maintains knowledge of Centers ... **It's more than a career, it's a calling** MO- REMOTE **Worker Type:** Regular **Job Highlights:** At SSM...vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete… more
- Bristol Myers Squibb (Devens, MA)
- …also serve as the Subject Matter Expert SME for the annual supplier Risk Assessment. The incumbent is involved in developing, modifying, and executing company ... supplier audit program as a team member and/or lead auditor . Serves as a Subject Matter Expert SME for...the Subject Matter Expert (SME) for the annual supplier Risk Assessment. + Author and maintain external audit schedule… more
- Molina Healthcare (Seattle, WA)
- **_ Remote and must live in Pacific Time Zone _**...+ Proficient with data and reports + Knowledge of risk adjustment + 1 year of experience in ... License (RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested in applying… more