94 coder 1 risk adjustment jobs found

Job Description 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 needed. Education and...

Our mission is to participate in Jesus Christ’s ministry, bringing health, healing, and wholeness to humanity by : Creating a supportive faculty practice framework that allows Loma Linda University School of Medicine physicians and surgeons to educate, conduct research, and deliver quality health care with optimum efficiency, deploying a motivated and competent workforce trained in customer service and whole person care principles and providing safe, seamless and satisfying health care encounters for patients while upholding the highest standards of fiscal integrity and clinical ethics. Our core values are compassion, integrity, humility, excellence, justice, teamwork and wholeness. 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...

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 regarding severity of illness and supporting clinical care plans for Hierarchical Condition Category (HCC) diagnoses. The role involves communication with providers to clarify documentation needs, providing education on documentation integrity, and keeping providers updated on CMS, ICD-10-CM, AHA Coding, and health plan guidelines related to risk adjustment. Performs other duties as needed. Education and Experience: Bachelor's degree in Health Information Management or related healthcare field preferred; equivalent education and experience may suffice. At least 2+ years of clinical/medical experience, including 1+ year in Risk Adjustment coding or Clinical Documentation Improvement/Specialist role. Knowledge and Skills: Understanding of electronic medical...

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 regarding severity of illness and supporting clinical care plans for Hierarchical Condition Category (HCC) diagnoses. The role involves communication with providers to clarify documentation needs, providing education on documentation integrity, and keeping providers updated on CMS, ICD-10-CM, AHA Coding, and health plan guidelines related to risk adjustment. Performs other duties as needed. Education and Experience: Bachelor's degree in Health Information Management or related healthcare field preferred; equivalent education and experience may suffice. At least 2+ years of clinical/medical experience, including 1+ year in Risk Adjustment coding or Clinical Documentation Improvement/Specialist role. Knowledge and Skills: Understanding of electronic medical...

Job Description Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. BENEFITS for Full and Part-time employees who work 30 or more hours per week: We pay 100% of the MEDICAL monthly premiums for Employee Only coverage. We pay 100%...

Employment Type: Full time Shift: Day Shift Description: The Coding Auditor & Educator performs medical record audits including analysis of medical record documentation; validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder's charge capture and coding with proper ICD-10, CPTs, HCPCs, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner. Educates practitioners on coding, documentation, and compliance matters. SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: 1. CPC, RHIT, CRC or CDEO accreditation is...

All the benefits and perks you need for you and your family: · Benefits from Day One · Career Development · Whole Person Wellbeing Resources · Mental Health Resources and Support Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. Shift : Monday-Friday Job Location : Remote The role you will contribute: The Coder Analyst IV is a Health Information Professional with a high level of coding and clinical proficiency necessary for the oversight of coding integrity, and ability to function as a liaison to the Quality and Clinical...

Job Description Job Description A certified professional coder and biller accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. She/he will also need to manage insurance claims, invoices and payments. At least 1 year of experience in the field is preferred. Training and on-going support provided. CPC certification and annual CME reimbursed. Must possess the following qualities: Detail oriented Analytical Possess technical skills Have integrity Have excellent communication skills. CPC certified, RISK Adjustment Certification a plus We offer competitive benefits including robust health, dental and vision insurance, free uniform, 401K with match, paid holiday time and paid time off after completion of probationary period, bonuses and much more! We are a team...

Job Description Job Description Description: Certified Coder reviews medical records to assure proper billing. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improve coding issues identified. Codes must meet QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Requirements: Essential Job Functions: CPC certification required through AAPC Excellent written and verbal communication skills Good interpersonal skills and team oriented Well organized and detail oriented Positive attitude, enthusiastic and energetic. At least one year of previous medical billing experience Previous primary care experience a plus Ability to perform well in a fast-paced team environment and to manage time effectively. In-depth knowledge of medical terminology, anatomy, physiology, and disease process. Comprehensive understanding of ICD-10-CM classification systems. Ability to read and analyze patient records...

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 Job Summary: Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education Develop process for chart review Assist coding leadership and clinical team by making recommendations for process improvements to further enhance coding goals and outcomes Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations Consistently maintain a minimum 95% accuracy on coding quality audits Meet minimum productivity requirements Ability to work independently in a remote environment Handle other related duties as...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

Facility University Medical Center of El Paso Department HIM NHC Schedule - Shift - Hours Full Time - Days The Certified Coding Auditor accurately codes, sequences, abstracts and audits outpatient medical records according to ICD-10-CM, CPT coding guidelines CPT coding guidelines and abstracts supported HCC (Hierarchical Condition Category Coding) diagnosis codes that are clinically significant in a risk adjustment payment model to achieve accurate and timely reimbursement and populate statistical databases. Queries physicians for clarification on documentation. Performs duties within approved practices, exercising independent judgment within pre-determined guidelines. Work Experience: Two years of outpatient coding experience required; experience with Hierarchical Condition Coding and Auditing preferred. License/Registration/Certification: Certified Professional Coder (CPC) or Certified Coding Specialist- Physician based (CCS-P) required Education and Training:...

Join to apply for the HCC Coding Auditor Senior - Health Plan Admin role at TieTalent . Get AI-powered advice on this job and more exclusive features. Summary The HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures. Responsibilities include quality assurance auditing and risk adjustment code abstraction for programs such as Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This position offers onsite work with a remote option. Responsibilities Perform medical record reviews and audits, including prospective, concurrent, and retrospective workflows, to ensure accurate diagnoses for risk adjustment. Conduct code abstraction and coding quality audits to support compliance with CMS (HCC) guidelines. Review...

Description Summary: HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk...

Job Description Job Description Job Title: HCC Coder Department: Risk Adjustment Hours per week: 40 F/T or P/T status: Full time Schedule/Hours : M-F, 8 am - 5 pm Job Summary Coordinates/Supports retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) risk adjustment coding to translate, input, extract and validate medical record data. Minimum Qualifications: High school diploma or equivalent (GED). AAPC/AHIMA certification. CRC ® certification required within 1 year of employment. Job Posted by ApplicantPro

Job Description Job Description Certified Risk Coder Center for Primary Care Who we are: For over 30 years the Center for Primary Care (CPC) has cared for families in the CSRA by providing patients with the most convenient, accessible, and personal healthcare available. Our mission is to improve the health and wellbeing of the families we serve by providing compassionate and high-quality care in a joyful setting. The physicians, healthcare professionals, and support team at our 9 practices, plus laboratory, imaging, and corporate locations work to transform our mission into action. What our employees say: At Center for Primary Care, we understand that the work environment is as important as the hard work you do. Center for Primary Care is Great Place to Work Certified which means our employees share feedback on their work culture experiences and we listen and strive to create positive employee experiences centered on joy, trust, and belonging. Learn more...

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. Description Hybrid Certified Coder - Family Practice Full-time Monday - Friday Hybrid, Day schedule (2 days in office, 3 days from home) $25.00 - $39.00/hour Non-Exempt Hybrid schedule: 2 days in office, 3 days from home Hybrid Certified Coder Family Practice Benefits: 401K after six months with up to 7% combined employer match and annual discretionary profit-sharing contribution Health, dental and vision benefits are available to all full-time employees and coverage becomes effective the first of the month following your date of hire. Practice paid life insurance. Full complement of voluntary benefits. $1,000 annual employer contribution to HSA if enrolled in CNYFC...

Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the organization billing/abstracting systems and to complete the coding function through established best practice processes and professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma...

Job Title: Coding Auditor SAMF Admin CBO (Full Time) Location: Fresno, Trinity Health Application Info: Join to apply. 4 days ago, among the first 25 applicants. Job Description Reporting to the Manager of Medical Group Revenue Cycle Site Operations in Fresno, this role involves performing medical record audits, analyzing documentation, validating diagnoses and procedures, and ensuring accurate coding according to CMS guidelines. The position also monitors the accuracy of charge capture and coding with ICD-10, CPT, HCPCS, and proper modifiers, adhering to local policies. The auditor partners with leadership to improve HCC and risk adjustment capture through provider and coder education. Responsibilities include ongoing review of medical records, coding, and practitioner education in documentation and compliance. Employment Details Type: Full-time Shift: Day Shift Pay Range: $31.99 - $43.19 Minimum Qualifications High school diploma or equivalent At least 2 years...

Working with Us Challenging. Meaningful. Life-changing. Those aren’t words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You’ll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible. Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us . Position reports to the Director of Medical Communications within WW...

Job Description Job Description Description: The Value Based Risk Adjustment Coding Advisor supports coding accuracy, medical record documentation, quality gap closure and provider education in the Community Health Clinics (CHC’s) participating in the CHPA Accountable Care Organization. The personnel in this position will use their knowledge of risk adjustment coding, documentation guidelines, and report generation to assist in any coding and auditing related functions determined by their direct supervisor or CCMCN leadership. Responsibilities: The Value Based Coding Advisor will interact with operational and clinical leadership to assist in the identification of Risk Adjustment/HCC coding opportunities, and will provide targeted education to CHC providers, billers, coders, and support staff to support value-based contract initiatives. Risk Adjustment/HCC Coding Support and Education Educates providers and staff on coding regulations and changes as they pertain to...

City/State Virginia Beach, VA Work Shift First (Days) Overview: Sentara Health is seeking to hire a qualified individual to join our team as Risk Adjustment Coder. Position Status : Full-time, Day Shift Position Location: Hybrid work model - 1 day week on-site in Virginia Beach; initial onboarding & training will be in-office Standard Working Hours : 8:00AM to 5:00PM Overview This role consists of educating primary & specialty care providers and staff on appropriate HCC coding & documentation, via virtual sessions and in-person site visits. Duties include retrospective auditing to ensure compliance with appropriate HCC coding & documentation guidelines. Education Associate degree required in healthcare administration, nursing, health information management, accounting, finance, or other related field or Iin lieu of associate's degree, 4 years of medical coding experience is required Certification/Licensure One of the...

About the job Inpatient Medical Coder Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to complex inpatient visit types. Complexity is measured by a Case Mix Index (CMI) and Coder II's typically see average CMI's of 2.2609. This index score demonstrates higher patient complexity and acuity. Utilizes expertise in clinical disease process and documentation, to assign Present on Admission (POA) values to all secondary diagnoses for quality metrics and reporting. Thoroughly reviews the provider notes within the health record and the Findings from the Clinical Documentation Nurse in the Clinical Documentation Improvement (CDI) Department who concurrently reviewed the record and provide their clinical insight on the diagnoses. Utilizes resources within 3M 360 CAC (Computerized Assisted Coding) software to efficiently review documentation and select or assign ICD-10-CM/PCS codes using autosuggestion or annotation features. Reviews Discharge...

JOB DESCRIPTION To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding directives....