4 coder 1 risk adjustment jobs found in Redlands, CA

Department: UHC: Managed Care-LLUHC/41077 Job Summary: The Coder 1 * Risk Adjustment is responsible for concurrent, prospective, and retrospective clinical documentation review as it pertains to Risk Adjustment Data Validation (RADV) timelines, with an emphasis on completeness and accuracy of provider documentation related to severity of illness and supporting clinical care plan(s) for the validation of Hierarchical Condition Category (HCC) diagnoses. Initiates communication, verbal and written, with providers to facilitate clarification of need for greater specificity, clinical support, and/or completeness of the progress notes. Provides compliant education related to documentation integrity, completeness, and consistency. Keeps providers up to date on CMS, ICD-10-CM, AHA Coding, health plan etc. guidelines as it pertains to Risk Adjustment for the purpose of, documentation trends and opportunities for improvement related to documentation integrity. Performs other duties as...

Department: UHC: Managed Care-LLUHC/41077 Job Summary: The Coder 1 * Risk Adjustment is responsible for clinical documentation review related to Risk Adjustment Data Validation (RADV) timelines, focusing on completeness and accuracy of provider documentation concerning severity of illness and supporting clinical care plans for Hierarchical Condition Category (HCC) diagnoses. Initiates communication with providers to clarify documentation needs and provides education on documentation integrity, completeness, and compliance with guidelines from CMS, ICD-10-CM, AHA Coding, and health plans. Performs other duties as needed. Education and Experience: Bachelor's degree in Health Information Management or a related healthcare field preferred; equivalent education and experience may be considered. Requires 2+ years of clinical/medical experience, including at least 1+ year of Risk Adjustment coding or Clinical Documentation Improvement experience. Knowledge and Skills: Understanding...

Job Description Job Description Salary: $20-45/hour DOE Certified Coder Bloom Value Corporation www.bloomvalue.com Bloom Value Corporation is a technology start up based in Sacramento, CA, USA. Founded by a diverse group of IT industry and healthcare leaders, Bloom Value is focused on financial and operational value optimization. Our founders include Enterprise AI pioneers, Finance and Operations experts, Change Management experts and Physicians. The team has Research, Development and Consulting experience across a broad range of industries and provider institutions. Bloom is looking for talented certified coders with a flair for technology and learning. Candidates will be using there coding skills to help clients with Risk Adjustment. Simultaneously, candidates will also be involved in helping develop AI Solutions to support risk coding. Job Location: Remote Job Type: Contract/Part Time With Opportunity To Convert To Full Time Core Job...

Job Overview Responsible for auditing all Senior HMO members' medical records to ensure accuracy of Risk-Adjustment data and reimbursement. Maintain a professional, positive and caring attitude at all times Duties Audit PCP, specialist and hospital records for additional HCC diagnoses. Audit all assigned providers wellness visits and send a CAP based on last year chronic conditions. Log the patients Prepare provider report card following completion of each PCP review utilizing comments function of qHMO. Forward provider report card to HCC Manager. Update encounter information with additional HCC data. Conduct Risk Adjustment Data Validation (RADV) audits as requested by HCC Manager. Orient providers in the use of qHMO and documentation for Risk Adjustment. Reinforce to providers the necessity for thorough and accurate documentation and reporting of Risk Adjusted diagnoses. Contact a provider when necessary to clarify medical record documentation....