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Internship Remote Risk Adjustment Coder Jobs in California

Urrly

Telehealth Nurse Practitioner

Los Angeles, CA · Remote

$600 - $720/day

Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ... Code with ICD-10 and CPT II * Deliver care plans and follow-up * Keep clean, audit-ready ...

Astrana Health, Inc.

$33 - $38/hr

... payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do * Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ...

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Internship Remote Risk Adjustment Coder information

What are some typical challenges faced by remote risk adjustment coding interns, and how can they effectively overcome them?

Remote risk adjustment coding interns often face challenges such as limited direct supervision, adapting to coding software, and maintaining accuracy while working independently. To overcome these, it's important to proactively seek feedback from mentors, participate in virtual team meetings, and utilize available training resources. Keeping organized notes and establishing a consistent work routine also help interns manage their workload and ensure coding quality. Engaging with the team through regular check-ins fosters a sense of connection and support, which is vital for professional development in a remote environment.

What is the difference between Internship Remote Risk Adjustment Coder vs Remote Risk Adjustment Coder?

AspectInternship Remote Risk Adjustment CoderRemote Risk Adjustment Coder
CredentialsTypically in training, may have basic coding certificationsUsually certified, such as CPC or CCS
Work EnvironmentRemote, internship setting, supervised learningRemote, full-time professional role
Employer UsageTraining programs, entry-level positionsEstablished companies, healthcare organizations
Search IntentLearning, entry-level opportunitiesProfessional coding, risk adjustment tasks

The Internship Remote Risk Adjustment Coder is an entry-level, supervised role designed for training and gaining experience in risk adjustment coding. In contrast, the Remote Risk Adjustment Coder is a full-fledged professional responsible for accurate coding and risk adjustment tasks independently. The internship offers a stepping stone into the industry, while the full role requires certification and experience.

What is an Internship Remote Risk Adjustment Coder?

An Internship Remote Risk Adjustment Coder is a trainee position where individuals learn to review and code medical records from a remote location to support risk adjustment programs. These coders assign diagnosis codes to patient records to ensure accurate documentation for health plans, which impacts reimbursement and compliance. Interns typically gain hands-on experience with coding guidelines, electronic health records, and industry software while working under the supervision of experienced coders. The remote aspect allows flexibility and access to positions regardless of geographic location.

What are the key skills and qualifications needed to thrive as an Internship Remote Risk Adjustment Coder, and why are they important?

To thrive as an Internship Remote Risk Adjustment Coder, you need a solid understanding of medical coding, anatomy, and healthcare documentation, usually supported by coursework in medical coding or a related certification such as CPC or CRC. Familiarity with coding software, electronic health records (EHRs), and risk adjustment systems is commonly required. Attention to detail, strong analytical skills, and effective communication are essential soft skills for interpreting complex records and collaborating remotely. These competencies ensure accurate coding, regulatory compliance, and effective risk adjustment processes critical to healthcare reimbursement.
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Internship Remote Risk Adjustment Coder jobs near you
Risk & Quality Performance Manager (Remote)

Risk & Quality Performance Manager (Remote)

Molina Healthcare

Long Beach, CA • Remote

Full-time

Posted 27 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

146th of 261 rated insurance

Job description

Job Description


Job Summary

The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.

Job Duties

 Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality rate trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors. 
 Monitor projects from inception through successful delivery.
 Oversee Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data.
 Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
 Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
 Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
 Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
 Proactively communicate risks and issues to stakeholders and leadership.
 Create, review, and approve program documentation, including plans, reports, and records.
 Ensure documentation is updated and accessible to relevant parties.
 Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.

Job Qualifications

REQUIRED EDUCATION:

Bachelor's degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

2+ years of program and/or project management experience in risk adjustment and/or quality
 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems
 2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners
 Familiarity with running queries in Microsoft Azure or SQL server
 Healthcare experience and functional risk adjustment and/or quality knowledge
 Mastery of Microsoft Office Suite including Excel and Project
 Experience partnering with various levels of leadership across complex organizations
 Strong quantitative aptitude and problem solving skills
 Intellectual agility and ability to simplify and clearly communicate complex concepts
 Excellent verbal, written and presentation capabilities
 Energetic and collaborative

PREFERRED EDUCATION:

Graduate degree or equivalent combination of education and experience

PREFERRED EXPERIENCE:

 Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements
 Experience working in a cross-functional, highly matrixed organization
 SQL proficiency
 Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired

#PJCorp

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

Social media

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