WI · On-site
$70 - $90/hr
Stay current on outpatient coding, risk adjustment, and regulatory guidance. * Ensure compliance with CMS, payer, and organizational documentation and billing requirements. * Identify potential ...
WI · On-site
$70 - $90/hr
Stay current on outpatient coding, risk adjustment, and regulatory guidance. * Ensure compliance with CMS, payer, and organizational documentation and billing requirements. * Identify potential ...
Consulting Actuary - ACA Risk Adjustment
Milwaukee, WI · On-site
$143K - $229K/yr
Manage external partnerships with vendors, auditors, regulators, and health care providers ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Consulting Actuary - ACA Risk Adjustment
Milwaukee, WI · On-site
$143K - $229K/yr
Manage external partnerships with vendors, auditors, regulators, and health care providers ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
WI · On-site
$100 - $231.54/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
WI · On-site
$100 - $231.54/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $231.54/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
WI · On-site
$100 - $231.54/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Oregon, WI · On-site
$100 - $232/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
Lead Director, Healthcare Medicaid Risk Adjustment Analytics
Oregon, WI · On-site
$100 - $232/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
WI · On-site
$100 - $232/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
WI · On-site
$100 - $232/hr
Knowledge of Medicaid Risk Adjustment * Working with Medicaid Risk models * Master's degree (e.g., Health Informatics, Data Science, Actuarial, Statistics, or MBA) preferred * Experience working ...
Lead Director, Risk Adjustment Performance Reporting and Insights
Oregon, WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
Lead Director, Risk Adjustment Performance Reporting and Insights
Oregon, WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
WI · On-site
$100 - $232/hr
... code and processes Preferred Qualifications * Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory ...
... risk adjustment methods, billing and revenue integrity policies, denials analysis and prevention to ... Registered Health Information Administrator (RHIA), or Registered Health Information Technology ...
... risk adjustment methods, billing and revenue integrity policies, denials analysis and prevention to ... Registered Health Information Administrator (RHIA), or Registered Health Information Technology ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... Develops educational materials for providers in relation to diagnostic coding and risk adjustment ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... Develops educational materials for providers in relation to diagnostic coding and risk adjustment ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... Develops educational materials for providers in relation to diagnostic coding and risk adjustment ...
Sanford Health, the largest rural health system in the United States, is dedicated to transforming ... Develops educational materials for providers in relation to diagnostic coding and risk adjustment ...
Lead Director, Medicare Advantage and Group ACA Risk Adjustment Informatics
Oregon, WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
Lead Director, Medicare Advantage and Group ACA Risk Adjustment Informatics
Oregon, WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
WI · On-site
$100 - $232/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Lead enterprise risk adjustment analytics supporting risk score completeness, accuracy, engagement ...
Telehealth Nurse Practitioner
Madison, WI · On-site +1
$600 - $720/day
Work from home and earn $600-$720 per day delivering telehealth visits on your schedule. Active ... Conduct Comprehensive Health Assessments via telehealth * Document risk adjustment (HCC coding ...
Telehealth Nurse Practitioner
Madison, WI · On-site +1
$600 - $720/day
Work from home and earn $600-$720 per day delivering telehealth visits on your schedule. Active ... Conduct Comprehensive Health Assessments via telehealth * Document risk adjustment (HCC coding ...
Hierarchical Condition Category (HCC) Coding Specialist
Madison, WI · On-site
$41.85/hr
Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS ... Registered Health Information Technician (RHIT) Preferred * None SKILLS * Critical Thinking
Hierarchical Condition Category (HCC) Coding Specialist
Madison, WI · On-site
$41.85/hr
Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS ... Registered Health Information Technician (RHIT) Preferred * None SKILLS * Critical Thinking
From Home Optum Health Coding Risk Adjustment information
What is the difference between From Home Optum Health Coding Risk Adjustment vs From Home Optum Health Medical Coding?
| Aspect | From Home Optum Health Coding Risk Adjustment | From Home Optum Health Medical Coding |
|---|---|---|
| Certifications | CCS, CPC, or RHIT/RHIA | CCS, CPC, or RHIT/RHIA |
| Work Environment | Remote, home-based | Remote, home-based |
| Industry Usage | Health insurance, risk adjustment programs | Healthcare providers, hospital coding |
| Job Focus | Risk adjustment coding for insurance accuracy | Clinical coding for medical records |
While both roles involve medical coding from home, From Home Optum Health Coding Risk Adjustment focuses on coding for insurance risk adjustment programs, requiring specific risk adjustment knowledge. In contrast, From Home Optum Health Medical Coding emphasizes clinical coding for medical records, often in hospital or provider settings. Both roles require similar certifications and offer remote work, but their primary focus and industry applications differ.
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For From Home Optum Health Coding Risk Adjustment jobs in Wisconsin, the most frequently searched job titles are:
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Cities in Wisconsin with the most From Home Optum Health Coding Risk Adjustment job openings:
CorroHealth rating
8.1
Based on 27 frontline employees who took The Breakroom Quiz
108th of 495 rated business services
Job description
Overview
#J-18808-LjbffrCDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures. This is a remote position.
Responsibilities- Review outpatient encounters (pre visit, concurrent, and/or post visit) to assess documentation accuracy and completeness.
- Identify opportunities for improved documentation related to: Chronic conditions and disease specificity; Risk adjustment (e.g., HCCs); Quality measures and medical necessity.
- Provide compliant documentation clarification via query and feedback to providers through approved communication channels.
- Support accurate problem list management and ongoing condition validation.
- Collaborate with coding, quality, compliance, and revenue cycle teams as needed.
- Track and report CDI interventions, trends, and outcomes.
- Participate in provider education and training initiatives.
- Stay current on outpatient coding, risk adjustment, and regulatory guidance.
- Ensure compliance with CMS, payer, and organizational documentation and billing requirements.
- Identify potential compliance risks, including but not limited to overcoding, undercoding, and missing and/or unsupported diagnoses.
- Apply knowledge of HCCs, risk adjustment, quality measures, and outpatient reimbursement methodologies as applicable.
- An active coding credential required such as RHIA, RHIT, CPC, COC, CCS-O, CCS, CDEO, CCDS, CDIP or CCDS-O
- 3+ years of outpatient coding, risk adjustment, outpatient CDI
- Strong understanding of: ICD-10-CM outpatient coding; Risk adjustment models (e.g., Medicare Advantage HCCs); Outpatient E/M documentation requirements
- Experience working in an ambulatory EHR (Epic, Cerner, or similar)
- Strong clinical and analytical judgment.
- Professional communication style.
- Excellent written documentation skills.
- Comfortable working independently in a fast-paced environment.
- Proficient in Microsoft Office Applications.
- Experience with telecommuting, working with EMRs and other electronic tools.
- Strong analytical skills.
- Strong Microsoft Office skills.
- Works well with numbers and as a strong team player.
- Ability to work with multiple and diverse clients and projects; ability to work with minimal supervision.
- Ability to maintain and access multiple files; assure that work product is completed with high levels of accuracy and attention to detail.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Regular eye-hand coordination and manual dexterity are required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, team members may be seated for prolonged periods. Infrequently, team members must be able to lift and move material weighing up to 20 lbs. Team members may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
NotesA job description is intended as a guideline and part of the team member’s function. It is not intended to be an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
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Pay
Benefits
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About CorroHealth
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Plano, TX, US
Year founded
2020