$143.62K - $229.79K/yr
Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their impact on risk adjustment outcomes. * Advanced analytical skills to identify risk adjustment leakage ...
$143.62K - $229.79K/yr
Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their impact on risk adjustment outcomes. * Advanced analytical skills to identify risk adjustment leakage ...
$18 - $24.25/hr
Provide overall coding expertise as well as administrative and technical oversight to ensure successful integration of Molina Medicare's Risk Adjustment initiatives. May require some travel to ...
$18 - $24.25/hr
Provide overall coding expertise as well as administrative and technical oversight to ensure successful integration of Molina Medicare's Risk Adjustment initiatives. May require some travel to ...
Columbus, OH · On-site
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Columbus, OH · On-site
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Columbus, OH · Hybrid
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Columbus, OH · Hybrid
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
New Albany, OH · On-site
$25/hr
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
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New Albany, OH · On-site
$25/hr
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
Columbus, OH · On-site +1
$90/hr
Our practices align with your professional Code of Ethics and all regulatory requirements. * Outcome measures: We continuously measure client outcomes and the therapeutic alliance throughout their ...
Columbus, OH · On-site +1
$90/hr
Our practices align with your professional Code of Ethics and all regulatory requirements. * Outcome measures: We continuously measure client outcomes and the therapeutic alliance throughout their ...
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
$99K - $139.50K/yr
Remote work is not available for this role. WHAT YOU'LL DO * Strong candidates are motivated by ... adjustments to our compliance program. Contribute to the development of audit process improvements.
$99K - $139.50K/yr
Remote work is not available for this role. WHAT YOU'LL DO * Strong candidates are motivated by ... adjustments to our compliance program. Contribute to the development of audit process improvements.
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
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Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
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Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
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Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
Quick apply
Columbus, OH · Remote
$40 - $75/hr
... of remote work and setting your own schedule. We are looking for a proficient Coder (part-time work from home) to help advance AI development. As a member of DataAnnotation's coding team, you'll be ...
$16.72 - $17.29
7% of jobs
$17.83 is the 25th percentile. Wages below this are outliers.
$17.29 - $17.86
19% of jobs
$17.86 - $18.43
5% of jobs
$18.43 - $19
3% of jobs
$19 - $19.57
14% of jobs
The median wage is $19.71 / hr.
$19.57 - $20.14
6% of jobs
$20.14 - $20.71
0% of jobs
$20.71 - $21.28
0% of jobs
$21.28 - $21.85
0% of jobs
$22.30 is the 75th percentile. Wages above this are outliers.
$21.85 - $22.42
26% of jobs
$22.42 - $22.99
20% of jobs
$16
$20
$22
| Aspect | Part Time Remote Risk Adjustment Coder | Part Time Remote Medical Coder |
|---|---|---|
| Certifications | AHIMA or AAPC Risk Adjustment certifications | CPR, CPC, or CCS certifications |
| Work Environment | Remote, healthcare insurance companies | Remote, hospitals, clinics, or healthcare facilities |
| Industry Usage | Health insurance, Medicare Advantage, Medicaid | Hospitals, clinics, outpatient facilities |
| Job Focus | Risk adjustment data, coding for reimbursement accuracy | Medical diagnoses, procedures, billing, and coding |
The main difference is that Part Time Remote Risk Adjustment Coders focus on coding for health insurance risk adjustment programs, requiring specific certifications and working primarily in insurance settings. In contrast, Part Time Remote Medical Coders handle a broader range of medical coding tasks in clinical environments. Both roles are remote and require coding certifications, but their industry focus and job responsibilities differ significantly.
$143.62K - $229.79K/yr
Other
Medical, Dental, Vision, Retirement, PTO
Posted 20 days ago
7.8
Based on 13 frontline employees who took The Breakroom Quiz
164th of 258 rated insurance
Job Description
As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments, evaluating advanced care management models, conducting competitive benchmarking analyses, and designing and pricing sophisticated insurance products. You will support company objectives by providing reliable, actionable actuarial insights and recommendations, proactively identifying and addressing complex risks and opportunities. This position requires adaptability to the evolving landscape of the industry, ensuring our actuarial practices remain at the forefront of innovation and excellence.What You'll Do
Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work
Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers
Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company
Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates
Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor
Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials
What You Bring
Bachelor's degree or advanced degree (where required)
Member of the American Academy of Actuaries
Fellow of the Society of Actuaries
7 years of relevant actuarial experience, related experience may be considered.
In lieu of an FSA, will consider candidates who are an Associate of the Society of Actuaries (ASA) and have at least 9 years of relevant actuarial experience.
Bonus Points
Deep experience with ACA Risk Adjustment, including HHS-HCC model methodology, risk score forecasting, and financial impact analysis - Highly Preferred
Proven expertise in ACA Risk Adjustment transfer forecasting and explanation of results to senior leadership - Highly Preferred
Strong understanding of diagnosis coding (ICD-10-CM), provider documentation practices, and their impact on risk adjustment outcomes.
Advanced analytical skills to identify risk adjustment leakage, emerging risks, and optimization opportunities across ACA populations
What You'll Get
The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.
Work-life balance, flexibility, and the autonomy to do great work.
Medical, dental, and vision coverage along with numerous health and wellness programs.
Parental leave and support plus adoption and surrogacy assistance.
Career development programs and tuition reimbursement for continued education.
401k match including an annual company contribution
Learn more
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.
Skills
Actuarial Analysis, Actuarial Management, Actuarial Science, Actuarial Services, Affordable Care Act (ACA), Complex Care Management, Financial Reporting and Analysis, Hiring Management, Insurance Industry, Organizational Leadership, Regulatory Compliance_____________________________________________________________________
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.
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Sourced by ZipRecruiter
Insurance services
5,001 - 10,000 Employees
Durham, NC, US
1933
