Medicare Risk Adjustment Jobs in Missouri (NOW HIRING)

A healthcare technology company is looking for an Actuarial Analyst III. This role focuses on delivering Medicare risk adjustment estimates and conducting complex revenue analysis. The ideal ...

A healthcare technology company is looking for an Actuarial Analyst III. This role focuses on delivering Medicare risk adjustment estimates and conducting complex revenue analysis. The ideal ...

Risk Adjustment Teams * Business Analysts * IT Teams * Vendor Partners * Healthcare Operations Stakeholders * Translate Medicare Advantage and Medicaid requirements into technical specifications.

This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA ...

This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA ...

This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA ...

This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA ...

This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA ...

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

In this role, you will perform in-home wellness visits and risk adjustment assessments for Medicare and other eligible patient populations. Your work will contribute to accurate clinical ...

In this role, you will perform in-home wellness visits and risk adjustment assessments for Medicare and other eligible patient populations. Your work will contribute to accurate clinical ...

In this role, you will perform in-home wellness visits and risk adjustment assessments for Medicare and other eligible patient populations. Your work will contribute to accurate clinical ...

In this role, you will perform in-home wellness visits and risk adjustment assessments for Medicare and other eligible patient populations. Your work will contribute to accurate clinical ...

Serves as the primary resource and subject matter expert on all CMS Risk Adjustment and quality ... Medicare HCC Mode; or any combination of education and experience, which would provide an ...

Recommends adjustments as needed to ensure appropriate, comprehensive, and cost-effective ... Medicare and Medicaid Conditions of Participation and Department of Health and Senior Services and ...

... care, provider performance, risk adjustment, and consumer analytics. • Partner with data ... data, Medicare and commercial health plan datasets • Demonstrated experience identifying and ...

Experience in handling claims denials, adjustments, and reprocessing * Strong exposure to EDI claim ... Experience in Member Enrollment workflows (Medicaid, Medicare, ACA) * Understanding of Billing ...

... adjustments, and reprocessing • Strong exposure to EDI claim and remittance transactions • ... Medicare, ACA) • Understanding of Billing lifecycle for member enrollment • Hands-on experience ...

Review and authorize large or complex medical bills, negotiating adjustments to control costs ... Oversee Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement.

Review and authorize large or complex medical bills, negotiating adjustments to control costs ... Oversee Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement.