... HCC Mode; or any combination of education and experience, which would provide an equivalent ... Prefer AAPC Certified Risk Adjustment Coder (CRC) certification. Job Level: Manager Workshift: 1st ...
... HCC Mode; or any combination of education and experience, which would provide an equivalent ... Prefer AAPC Certified Risk Adjustment Coder (CRC) certification. Job Level: Manager Workshift: 1st ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... Risk Adjustment initiatives. May require some travel to various provider partner locations Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model. Develop an understanding ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... Risk Adjustment initiatives. May require some travel to various provider partner locations Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model. Develop an understanding ...
Consulting Actuary - ACA Risk Adjustment
Columbus, OH · On-site
$143K - $229K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Consulting Actuary - ACA Risk Adjustment
Columbus, OH · On-site
$143K - $229K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
HIM Coder - Professional
Portsmouth, OH · On-site
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
HIM Coder - Professional
Portsmouth, OH · On-site
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Director, Model Engineering & Operations
Dayton, OH · On-site
$136 - $237/hr
Lead the design, development, and productionization of ML and AI models across risk adjustment (HCC ... Code practices. * Hands-on proficiency with Databricks (or comparable lakehouse platform), Delta ...
Director, Model Engineering & Operations
Dayton, OH · On-site
$136 - $237/hr
Lead the design, development, and productionization of ML and AI models across risk adjustment (HCC ... Code practices. * Hands-on proficiency with Databricks (or comparable lakehouse platform), Delta ...
Director, Model Engineering & Operations
Dayton, OH · On-site +1
Lead the design, development, and productionization of ML and AI models across risk adjustment (HCC ... Code practices * Hands-on proficiency with Databricks (or comparable lakehouse platform), Delta ...
Director, Model Engineering & Operations
Dayton, OH · On-site +1
Lead the design, development, and productionization of ML and AI models across risk adjustment (HCC ... Code practices * Hands-on proficiency with Databricks (or comparable lakehouse platform), Delta ...
Remote Nurse Practitioner
OH · Remote
Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background in home‑based care, transitional care, or chronic disease management Overview Salary 135k Join ...
Quick apply
Remote Nurse Practitioner
OH · Remote
Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background in home‑based care, transitional care, or chronic disease management Overview Salary 135k Join ...
... HCC conditions * ICD-10-CM coding principles, including clinical specificity, laterality, condition relationships, and complications * CMS risk-adjustment requirements and organizational ...
... HCC conditions * ICD-10-CM coding principles, including clinical specificity, laterality, condition relationships, and complications * CMS risk-adjustment requirements and organizational ...
Community Based Quality Advanced Practice Provider
Columbus, OH · On-site
$16.75 - $22.75/hr
Experience with risk adjustment, HCC coding, and clinical documentation standards (DSP/MEAT criteria)-candidates without this background will receive structured training. * Multi-setting background ...
Community Based Quality Advanced Practice Provider
Columbus, OH · On-site
$16.75 - $22.75/hr
Experience with risk adjustment, HCC coding, and clinical documentation standards (DSP/MEAT criteria)-candidates without this background will receive structured training. * Multi-setting background ...
Quality Community Based Advanced Practice Provider
Cleveland, OH · On-site
$17.50 - $23.50/hr
Experience with risk adjustment, HCC coding, and clinical documentation standards (DSP/MEAT criteria)-candidates without this background will receive structured training. * Multi-setting background ...
Quality Community Based Advanced Practice Provider
Cleveland, OH · On-site
$17.50 - $23.50/hr
Experience with risk adjustment, HCC coding, and clinical documentation standards (DSP/MEAT criteria)-candidates without this background will receive structured training. * Multi-setting background ...
Field Nurse Practitioner / Physician Assistant - Montgomery County, Ohio
Dayton, OH · On-site
$137.76/hr
Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care.
Field Nurse Practitioner / Physician Assistant - Montgomery County, Ohio
Dayton, OH · On-site
$137.76/hr
Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care.
Compliance Educator
Columbus, OH · On-site
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Compliance Educator
Columbus, OH · On-site
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Compliance Educator
Columbus, OH · Hybrid
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Compliance Educator
Columbus, OH · Hybrid
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers ... Liaise with office and laboratory staff to provide reimbursement support and test coding.
Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers ... Liaise with office and laboratory staff to provide reimbursement support and test coding.
Freelance Hcc Risk Adjustment Coder information
What is a freelance HCC risk adjustment coder?
What are the key skills and qualifications needed to thrive as a freelance HCC risk adjustment coder?
How does a freelance HCC risk adjustment coder typically collaborate with healthcare providers and coding teams remotely?
What is the difference between Freelance Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?
| Aspect | Freelance Hcc Risk Adjustment Coder | Hcc Risk Adjustment Coder |
|---|---|---|
| Credentials | Certifications in medical coding, HCC coding experience | Certifications in medical coding, HCC coding experience |
| Work Environment | Remote, independent contracting | Typically employed by healthcare organizations or coding companies |
| Employer & Industry Usage | Freelance platforms, independent practice | Hospitals, insurance companies, healthcare providers |
| Search & Comparison Intent | Looking for freelance opportunities or contract work | Seeking full-time or staff coding roles |
Both roles require similar certifications and skills in HCC coding. The main difference is that a Freelance Hcc Risk Adjustment Coder works independently on a contract basis, often remotely, while an Hcc Risk Adjustment Coder is typically employed full-time by healthcare organizations. Your choice depends on your preferred work environment and employment type.
What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Ohio?
The most popular types of Hcc Risk Adjustment Coder jobs in Ohio are:
What are popular job titles related to Freelance Hcc Risk Adjustment Coder jobs in Ohio?
For Freelance Hcc Risk Adjustment Coder jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Freelance Hcc Risk Adjustment Coder jobs in Ohio look for?
The top searched job categories for Freelance Hcc Risk Adjustment Coder jobs in Ohio are:
What cities in Ohio are hiring for Freelance Hcc Risk Adjustment Coder jobs?
Cities in Ohio with the most Freelance Hcc Risk Adjustment Coder job openings:
Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA)
Mason, OH • On-site
7.6
Based on 353 frontline employees who took The Breakroom Quiz
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Posted 25 days ago
Job description
Manager Clinical Performance & Quality Coding
LOCATION: The position requires that you be in the office 3x per week. You must be within a commutable distance of one of our eligible offices.
HOURS: General business hours, Monday through Friday (8-5 central)
Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Responsible for leading the quality documentation and value capture for all provider visit medical encounters to ensure application of accurate diagnosis codes (ICD-10 codes).
Primary duties include but not limited to:
- Serves as the primary resource and subject matter expert on all CMS Risk Adjustment and quality documentation.
- Develop and deliver clinical focused training on advance coding and documentation while incorporating coder feedback.
- Liaison to the clinical leadership on alignment of goals and workflows to support value capture initiatives and high-quality clinical documentation.
- Develop performance management plan, KPI's and clinical level tracking to meet quarterly goals for coding timeliness, accuracy, and Risk Adjustment.
- Develop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures.
- Develop operational and clinical workflows for closing HEDIS care opportunities to ensure practices and health plan success.
- Participate in peer review of medical documentation for completed visits notes as well as patient profile information in EMR.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Required Qualifications
- Current, active, valid, and unrestricted nurse practitioner (NP) or PA license in applicable state(s) required.
- Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
- Requires experience with CMS Risk Models.
Preferred Qualifications
- You must have previous management/supervisory experience with direct reports.
- HEDIS experience is preferred.
- Experience with clinical data/documentation integrity is preferred (CDEO or CDEI).
- Prefer AAPC Certified Risk Adjustment Coder (CRC) certification.
Job Level: Manager
Workshift: 1st Shift (United States of America)
Job Family: MED > Licensed Nurse
About Elevance Health
Sourced by ZipRecruiter
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Indianapolis, IN, US
Year founded
2004
Website
What Elevance Health employees say
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Benefits
Hours and flexibility
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