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Risk Adjustment Coding Manager Jobs in Indiana (NOW HIRING)

DaVita

What sets DaVita IKC apart is that we not only provide great care management but we start with our heart with our patients and each other. We focus on creating both a great experience for our ...

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Varsity Tutors

Finance Tutor

Indianapolis, IN · Remote

$40/hr

... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ... management courses. * Effective Teaching Methods: Ability to identify concepts students commonly ...

Varsity Tutors

Finance Tutor

Fort Wayne, IN · Remote

$40/hr

... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ... management courses. * Effective Teaching Methods: Ability to identify concepts students commonly ...

Varsity Tutors

Finance Tutor

Bloomington, IN · Remote

$40/hr

... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ... management courses. * Effective Teaching Methods: Ability to identify concepts students commonly ...

Varsity Tutors

Finance Tutor

West Lafayette, IN · Remote

$40/hr

... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ... management courses. * Effective Teaching Methods: Ability to identify concepts students commonly ...

Varsity Tutors

Finance Tutor

Valparaiso, IN · Remote

$40/hr

... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ... management courses. * Effective Teaching Methods: Ability to identify concepts students commonly ...

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Risk Adjustment Coding Manager information

What are some common challenges faced by Risk Adjustment Coding Managers, and how can they effectively address them?

Risk Adjustment Coding Managers often encounter challenges such as ensuring coding accuracy, keeping up with regulatory changes, and coordinating across multidisciplinary teams. To address these, effective managers implement rigorous quality assurance processes, provide ongoing coder education, and maintain open communication with clinical, compliance, and data analytics teams. Staying updated on CMS guidelines and fostering a culture of continuous improvement are also key strategies for success in this role.

What are the key skills and qualifications needed to thrive as a Risk Adjustment Coding Manager, and why are they important?

To thrive as a Risk Adjustment Coding Manager, you need expertise in medical coding (CPT, ICD-10), risk adjustment methodologies, and a background in healthcare management, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with coding software, EHR systems, and data analytics tools is typically required. Strong leadership, attention to detail, and the ability to communicate compliance standards effectively are crucial soft skills. These skills ensure accurate risk adjustment coding, regulatory compliance, and improved financial outcomes for healthcare organizations.

What is the difference between Risk Adjustment Coding Manager vs Risk Adjustment Coder?

AspectRisk Adjustment Coding ManagerRisk Adjustment Coder
CertificationsAHIMA or AAPC credentials, management experienceAHIMA or AAPC credentials, coding certification
Work EnvironmentSupervisory role, overseeing coding teamsPerforming coding tasks directly on patient records
Employer & IndustryHealth plans, healthcare providers, insurance companiesHospitals, clinics, health plans

The Risk Adjustment Coding Manager oversees coding teams and ensures compliance, while the Risk Adjustment Coder focuses on accurately coding patient records. Both roles require similar certifications but differ in responsibilities and work environment, with managers handling supervision and coders performing detailed coding tasks.

What are Risk Adjustment Coding Managers?

Risk Adjustment Coding Managers are professionals responsible for overseeing the medical coding process related to risk adjustment in healthcare organizations. They ensure accurate coding of diagnoses and procedures to reflect the health status of patients, which is essential for proper reimbursement from Medicare Advantage and other insurance plans. These managers lead teams of coders, maintain compliance with regulations, and implement quality assurance processes to optimize coding accuracy and organizational performance.
What are the most commonly searched types of Risk Adjustment Coding jobs in Indiana? The most popular types of Risk Adjustment Coding jobs in Indiana are:
What are popular job titles related to Risk Adjustment Coding Manager jobs in Indiana? For Risk Adjustment Coding Manager jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Risk Adjustment Coding Manager jobs in Indiana look for? The top searched job categories for Risk Adjustment Coding Manager jobs in Indiana are:
What cities in Indiana are hiring for Risk Adjustment Coding Manager jobs? Cities in Indiana with the most Risk Adjustment Coding Manager job openings:
Risk Adjustment Coding Manager jobs near you
Senior Healthcare Data Analyst: ACA + EDGE

Senior Healthcare Data Analyst: ACA + EDGE

Blue Cross and Blue Shield of North Carolina

Indianapolis, IN

$82K - $103K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

166th of 260 rated insurance

Job description

Job Description

We are seeking a highly skilled Senior Data Analyst with deep expertise in Affordable Care Act (ACA) Risk Adjustment and EDGE server submissions. This role will serve as a key liaison between business stakeholders, risk adjustment operations, and technical teams to ensure the accuracy, completeness, and timeliness of EDGE data submissions and reporting.
The ideal candidate will have strong experience with ACA data flows (enrollment, claims, supplemental), HCC modeling, and reconciliation of EDGE outputs, along with advanced analytical and data validation skills.
In this role you will be responsible for providing complex analytic support, which includes data collection, trending, reporting and forecasting functions to effectively assist departments/divisions with decision making. Prepares complex data for various internal and external customers, such as Department of Insurance (DOI), lawyers, external auditors, contracting vendors, employee groups, internal physician and hospital contracting staff, financial/medical expense staff and other divisions/programs.

What You'll Do

  • Construct, design, write and document complex programs using Business Intelligence Tools (e.g. Business Objects, SAS, SQL, Crystal Reports) to gather statistical data, ensuring that the most efficient procedures are used to access, investigate, and analyze data.

  • Develop, analyze, report and interpret complex data for ongoing activities/projects. Ensure that all data is accurate and available to meet establish deadlines.

  • Work collaboratively with customers to complete effective needs analyses to successfully provide analytic support and problem solving assistance to business areas.

  • Monitor and perform in-depth analysis of data for customers to determine areas of improvement or where investigation is needed.

  • Identify complex data problems and issues and is responsible for resolution.

  • Identify complex trends and make recommendations to business areas to effectively assist them with decision making on operational or other business issues.

  • Communicate meaningful insights by creating charts and slide presentations and presenting findings to all levels of leadership staff.

  • Maintain and coordinate existing cross-functional programs, and create and develop new programs.

  • Support and manage complex applications systems on many platforms and manage code migrations and changes between different applications environments.

  • Develop, maintain, and monitor reports on system security to ensure user access is appropriate for the specific division. Provide ongoing user support for ad hoc reporting, questions, queries, and problem support

  • Ensure appropriate security and privacy for all data that contains PHI fields. Resolve all security and privacy issues in the data.

  • Represent department on enterprise project teams and process optimization efforts as needed.

  • Serve as a mentor/coach for less experienced employees.

What You Bring

  • Bachelor's degree or advanced degree (where required)

  • 5+ years of experience in related field.

  • In lieu of degree, 7+ years of experience in related field.

WhatYou'llGet

  • The opportunity to work at thecutting edgeof health care delivery with a teamthat'sdeeply invested in the community

  • Work-life balance, flexibility, and the autonomy to dogreat work

  • Medical, dental, and vision coverage along withnumeroushealth and wellness programs

  • Parental leave and support plus adoption and surrogacyassistance

  • Career development programs and tuition reimbursement for continued education

  • 401k match including an annual company contribution

  • Learn more

WhereYou'llWork

Our Hybrid Flex approach is builton presencewith a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplacethat'sflexible, connected, and future focused.

In a Hybrid-Flex role,you'llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you'llwork virtually, with a few in-office visits each year formeaningfulmoments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in anystateslistedonthis job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$89,174.00 - $142,679.00

Skills

Business Analysis, Business Data Analysis, Business Intelligence (BI), Cloud Applications, Code Collaborator, Communication, Consulting, Data Warehousing (DW), Health Insurance Industry, Peer Development, Problem Solving, Statistical Models, Structured Query Language (SQL)

_____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

What Blue Cross and Blue Shield of North Carolina employees say

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