Newark, NJ · On-site
$23.75 - $31.75/hr
... commercial risk adjustment and developing educational materials for Network Management ... coding performance and member health status using existing tools and performing ad hoc analysis ...
Newark, NJ · On-site
$23.75 - $31.75/hr
... commercial risk adjustment and developing educational materials for Network Management ... coding performance and member health status using existing tools and performing ad hoc analysis ...
Clinical Team Collaboration & Provider Education: * Proactively collaborate with Highmark clinical ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
Clinical Team Collaboration & Provider Education: * Proactively collaborate with Highmark clinical ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
New York, NY · On-site +1
EDUCATION Minimum * High School Diploma / GED Substitutions * None Preferred * Bachelor's degree in ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
New York, NY · On-site +1
EDUCATION Minimum * High School Diploma / GED Substitutions * None Preferred * Bachelor's degree in ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
Manhattan, NY · Remote
$72K - $82K/yr
Position Overview The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to ... Required Education, Training & Professional Experience * Bachelor's degree required, preferably in ...
Manhattan, NY · Remote
$72K - $82K/yr
Position Overview The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to ... Required Education, Training & Professional Experience * Bachelor's degree required, preferably in ...
Position Overview The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to ... Required Education, Training & Professional Experience * Bachelor's degree required, preferably in ...
Position Overview The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to ... Required Education, Training & Professional Experience * Bachelor's degree required, preferably in ...
Manhattan, NY · On-site
$72K - $82K/yr
Position Overview The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to ... Required Education, Training & Professional Experience * Bachelor's degree required, preferably in ...
Manhattan, NY · On-site
$72K - $82K/yr
Position Overview The Risk Adjustment Medical Record Retrieval Specialist will lead efforts to ... Required Education, Training & Professional Experience * Bachelor's degree required, preferably in ...
New York, NY · On-site +1
Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs ... and/or education required * 4+ years health insurance actuarial experience, preferably in the ...
New York, NY · On-site +1
Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs ... and/or education required * 4+ years health insurance actuarial experience, preferably in the ...
Manhattan, NY · On-site
Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs ... and/or education required * 4+ years health insurance actuarial experience, preferably in the ...
Manhattan, NY · On-site
Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs ... and/or education required * 4+ years health insurance actuarial experience, preferably in the ...
New York, NY · On-site
$77K - $149K/yr
Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs ... and/or education required * 4+ years health insurance actuarial experience, preferably in the ...
New York, NY · On-site
$77K - $149K/yr
Work closely with Risk Adjustment and other areas to optimize risk adjustment and related programs ... and/or education required * 4+ years health insurance actuarial experience, preferably in the ...
$120K - $135K/yr
Lead end-to-end RCM across all payer types, with primary focus on Original Medicare and value-based ... Experience with HCC coding, risk adjustment suspecting, and chart review workflows * Familiarity ...
Quick apply
$120K - $135K/yr
Lead end-to-end RCM across all payer types, with primary focus on Original Medicare and value-based ... Experience with HCC coding, risk adjustment suspecting, and chart review workflows * Familiarity ...
... Medicare Advantage, Medicaid managed care, exchange, and other health plan arrangements require ... methodology, coding, claim adjudication, stop-loss, risk adjustment, value-based care, network ...
... Medicare Advantage, Medicaid managed care, exchange, and other health plan arrangements require ... methodology, coding, claim adjudication, stop-loss, risk adjustment, value-based care, network ...
... Medicare Advantage, Medicaid managed care, exchange, and other health plan arrangements require ... methodology, coding, claim adjudication, stop-loss, risk adjustment, value-based care, network ...
... Medicare Advantage, Medicaid managed care, exchange, and other health plan arrangements require ... methodology, coding, claim adjudication, stop-loss, risk adjustment, value-based care, network ...
... Educator. * Assists the coding staff when needed. * Keeps abreast of coding guidelines and reimbursement reporting requirements, new technology and procedures as well as Centers for Medicare ...
... Educator. * Assists the coding staff when needed. * Keeps abreast of coding guidelines and reimbursement reporting requirements, new technology and procedures as well as Centers for Medicare ...
Neptune, NJ · On-site
$97K/yr
... Educator. * Assists the coding staff when needed. * Keeps abreast of coding guidelines and reimbursement reporting requirements, new technology and procedures as well as Centers for Medicare ...
Neptune, NJ · On-site
$97K/yr
... Educator. * Assists the coding staff when needed. * Keeps abreast of coding guidelines and reimbursement reporting requirements, new technology and procedures as well as Centers for Medicare ...
New York, NY · Hybrid
$163K - $215K/yr
The Risk Adjustment Data Science team turns that data into the models, pipelines, and systems that ... code review, and testing Bonus points: * Advanced degree in a quantitative or technical field
New York, NY · Hybrid
$163K - $215K/yr
The Risk Adjustment Data Science team turns that data into the models, pipelines, and systems that ... code review, and testing Bonus points: * Advanced degree in a quantitative or technical field
New York, NY · Remote
$19.25 - $25.50/hr
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing ... Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and ...
New York, NY · Remote
$19.25 - $25.50/hr
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing ... Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and ...
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing ... Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and ...
Educate providers on Medicare quality programs and CMS-HCC Risk Adjustment methodology, emphasizing ... Support providers in ensuring documentation aligns with ICD-10 and CPT II coding guidelines and ...
$79K - $105K/yr
... across ACA, Medicare Advantage, and Medicaid. Responsibilities include analyzing risk scores ... Perform or support data analytics and reporting to inform risk adjustment operations, strategy ...
$79K - $105K/yr
... across ACA, Medicare Advantage, and Medicaid. Responsibilities include analyzing risk scores ... Perform or support data analytics and reporting to inform risk adjustment operations, strategy ...
New York, NY · On-site
$163K - $215K/yr
The Risk Adjustment Data Science team turns that data into the models, pipelines, and systems that ... code review, and testing Bonus points: * Advanced degree in a quantitative or technical field
New York, NY · On-site
$163K - $215K/yr
The Risk Adjustment Data Science team turns that data into the models, pipelines, and systems that ... code review, and testing Bonus points: * Advanced degree in a quantitative or technical field
Newark, NJ · On-site +1
$79K - $105K/yr
... across ACA, Medicare Advantage, and Medicaid. Responsibilities include analyzing risk scores ... Perform or support data analytics and reporting to inform risk adjustment operations, strategy ...
Newark, NJ · On-site +1
$79K - $105K/yr
... across ACA, Medicare Advantage, and Medicaid. Responsibilities include analyzing risk scores ... Perform or support data analytics and reporting to inform risk adjustment operations, strategy ...
| Aspect | Medicare Risk Adjustment Coding Educator | Medicare Coding Specialist |
|---|---|---|
| Certifications | AHIMA or AAPC certifications, risk adjustment training | AHIMA or AAPC coding certifications, Medicare-specific coding credentials |
| Work Environment | Training sessions, educational settings, healthcare organizations | Clinical coding departments, healthcare facilities, insurance companies |
| Employer & Industry Usage | Hospitals, health plans, educational institutions | Hospitals, clinics, insurance providers |
The Medicare Risk Adjustment Coding Educator focuses on training healthcare professionals in risk adjustment coding principles, while the Medicare Coding Specialist applies coding directly to patient records and claims. Both roles require coding certifications and knowledge of Medicare guidelines, but educators emphasize teaching and compliance, whereas specialists focus on accurate coding for reimbursement.
Newark, NJ • On-site
$23.75 - $31.75/hr
Contractor
Re-posted 5 days ago
A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
This is Contract position with my direct client
Direct Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be : Newark, NJ OR West Trenton OR Ewing OR Wall, NJ
Duration: Contract to Hire
Job Summary:
The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for Network Management professionals to communicate with providers and staff regarding client's risk adjustment programs.
Primary responsibilities include working with the Risk Adjustment Management Business Analyst to measure commercial risk adjustment performance for the development of education materials.
Ongoing responsibilities include communicating and educating Network Management Provider Educators to enable content delivery to specific providers.
This role will operate within the Risk Adjustment Management function, but work closely with the Network Management team. Responsibilities: Operates as the intermediary between the Risk Adjustment Management team and provider-facing staff to report and deliver commercial risk adjustment insights
Works closely with the Risk Adjustment Management Business Analyst to monitor risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis Collaborates with the Network Management leadership in developing, monitoring and driving key performance metrics for Network Management Provider Educators
Collaborates with the Network Management leadership in developing and delivering commercial risk adjustment educational content and materials for internal and external use, including clinicians and supporting staff Validates documentation against submitted claims diagnosis codes and prepares detailed reports Supports Risk Adjustment Data Validation audits Drives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work streams are accurately identified and addressed Provides status reports to management
Certifications:
AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)
Knowledge:
Understands key tenets of commercial risk adjustment and the HHS-HCC risk adjustment model Mastery of medical coding best practices
Project management skills
Experience displaying ability to think analytically
Strong communications and presentation skills Computer skills: Outlook, Excel, Word & Powerpoint;
Contact me at 732 429 1953
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Recruiting and staffing services
51 - 200 Employees
Edison, NJ, US
1996
