Hcc Risk Adjustment Coding Jobs in Dallas, TX (NOW HIRING)

Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV'

Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred)

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: • Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC ...

This role will provide strategic leadership across client engagements, with a particular focus on coding compliance, revenue cycle operations, and risk adjustment (RADV/HCC). The Director will play a ...

Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...

Will review all provider visit medical encounters and apply most appropriate diagnosis codes. * Overall accountability for the HCC/Risk Adjustment of goals and workflows to support value capture ...

Will review all provider visit medical encounters and apply most appropriate diagnosis codes. * Overall accountability for the HCC/Risk Adjustment of goals and workflows to support value capture ...

Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors. * Provides expertise as it relates to coding compliance for new and existing services, while ...

Analyze existing code and business processes to recommend scalable, efficient solutions during ... Commercial Risk Adjustment experience is highly preferred. * Experience with CMS Risk Adjustment ...

... HCC Mode; or any combination of education and experience, which would provide an equivalent ... Prefer AAPC Certified Risk Adjustment Coder (CRC) certification. Please be advised that Elevance ...

... HCC (Hierarchical Condition Category) coder you will review medical records to identify and code ... for risk adjustment and reimbursement purposes. You will play a critical role in translating ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...

Strong understanding of payer policies, claims processing, medical necessity guidelines, and risk adjustment methodologies. * Experience in coding audits, denial resolution, and revenue integrity ...