Top 690 Risk adjustment Jobs in Los Angeles, Ca

Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid)
UCLA Health —Los Angeles, CA
- $95,400 - $208,300 a year
- Anatomy knowledge
- Microsoft Outlook
- RN License
Risk Adjustment Registered Nurse (RN)
CareLinx by Sharecare —Fullerton, CA
- $55 - $60 an hour
- Part-time
- Nursing
- RN License
- Writing skills
- Health insurance
- Paid time off
Senior Manager, Risk Adjustment
Imperial Management Administrators Services Inc —Pasadena, CA
- $100,000 - $150,000 a year
- 5 years
- HIPAA
- English
Quick Apply
HCC Coding Specialist
MedPOINT Management —Sherman Oaks, CA
- $75,000 - $95,000 a year
- Full-time
- Hybrid work
- Mid-level
- 2 years
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
4d
Strategy & Operations Associate - Insurance Solutions
Apollo —El Segundo, CA
- $115,000 - $130,000 a year
- Full-time
- Mid-level
- Office
- 3 years
Medical Records Specialist (Agency Temp)
Prosper Services LLC —Compton, CA
- Full-time
- Current TB test
- Medical office experience
- HIPAA
Quick Apply
Clinical Social Worker
St Mary Medical Center —Long Beach, CA
- $42.90 - $50.99 an hour
- Full-time
- Acute care
- Hospital
- BLS Certification
13d
Manager, Compliance
Warner Bros. Discovery —Burbank, CA
- $86,800 - $161,200 a year
- Full-time
- 3 years
- Contracts
- Senior level
- Wellness program
- Paid holidays
6d
Licensed Clinical Social Worker-Hybrid
Partners in Care Foundation, Inc. —San Fernando, CA
- $36 - $42 an hour
- Full-time
- Hybrid work
- Spanish
- Microsoft Outlook
- Computer literacy
- Health savings account
- Health insurance
Quick Apply
Ecommerce Manager
Pixio USA Inc —Torrance, CA
- $80,000 - $100,000 a year
- Full-time
- Merchandising
- 3 years
- Continuous improvement
- Paid holidays
- Health insurance
Quick Apply
BCBA Consultant
Dalton Home Care —Gardena, CA
- $50 - $75 an hour
- Part-time
- Background check
- Applied behavior analysis
- Writing skills
- Flexible schedule
Quick Apply
EPL & D&O Liability Claim Counsel
Travelers —Diamond Bar, CA
- $111,600 - $184,200 a year
- Analysis skills
- Bachelor's degree
- Children
- Wellness program
- Paid holidays
Clinical Quality Improvement RN
TotalMed Medfi —Los Angeles, CA
- From $60 an hour
- Full-time
- Background check
- Nursing
- RN License
- Travel reimbursement
- Mileage reimbursement
Quick Apply
Division Credit Manager - Consumer, SBA, Business Banking, Card
City National Bank —Los Angeles, CA
- $195,995 - $364,003 a year
- 7 years
- Finance
- Analysis skills
- Health insurance
- Dental insurance
MACHINE MAINTENANCE TECHNICIAN III
Marvin Engineering Co. —Inglewood, CA
- $38 - $49 an hour
- Online Application
- Engineering
- English
- Research
Quick Apply
Assistant Operations Manager
Performance Team —Santa Fe Springs, CA
- $66,560 - $72,500 a year
- Full-time
- Mid-level
- High school diploma or GED
- Fair chance
- Health insurance
- Dental insurance
Social Work Educator
Partners in Care Foundation, Inc. —San Fernando, CA
- $26 - $32 an hour
- Full-time
- Hybrid work
- Background check
- Master of Social Work
- Licensed Clinical Social Worker
- Health insurance
- Dental insurance
Quick Apply
7d
Operations Manager-3rd shift
Performance Team —Santa Fe Springs, CA
- Full-time
- High school diploma or GED
- Team management
- Fair chance
- Health insurance
- Dental insurance
10d
Quality Control Technician, 2nd Shift
PPG —Sylmar, CA
- $29.15 - $30.92 an hour
- Urgently hiring
- Mid-level
- High school diploma or GED
- Ability to lift 50 pounds
Quick Apply
Heavy-Civil Project Manager
RimePro Inc —Los Angeles, CA
- $120,000 - $150,000 a year
- Full-time
- Construction site
- 5 years
- Office
- Paid holidays
- Dental insurance
Quick Apply

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risk adjustment jobs near los angeles, ca

Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid)

UCLA Health -
Los Angeles, CA

Apply Now

Job Details

$95,400 - $208,300 a year

Qualifications

Anatomy knowledge
Microsoft Outlook
Clinical compliance checks
Medicare
Health education for healthcare providers
CMS
Word embeddings
HIPAA
Healthcare documentation compliance audits
Medical coding experience in physician offices
Medical coding experience in outpatient clinics
Clinical staff training
Health insurance knowledge
Medicare regulations
Clinical training
Clinical information systems
Clinical documentation
Centers for Medicare & Medicaid Services (CMS) billing regulations
Clinical documentation improvement
Clinical documentation standards
HEDIS
Medical record review for billing accuracy

Full Job Description

Description

As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will:

Conduct medical record audits for physicians (MD, DO, or NP) to ensure documentation and coding accuracy of ICD-10 CM codes related to chronic conditions
Analyze coding patterns within medical groups.
Provide customized education and updating educational materials for providers and medical groups.
Participate in additional audit activities for CMS RADV as needed, including retrospective chart reviews.
Travel to provider offices within Los Angeles area at least three days a week.

UCLA Health salary range for this title code is $95,400-208,300/annually. Please note that the department's target pay range is $95,400 - $120,000/annually.

Qualifications

We are seeking a proactive, highly organized, detail-oriented individual with:

Required:

A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification
A Certified Risk Adjustment Coder (CRC)
Reliable transportation to conduct ongoing face-to-face interactions with providers in the Los Angeles area
Five or more years of experience with physician billing and/or coding
Three or more years of recent experience in CMS-HCC Risk Adjustment models V24 and V28
Three or more years of experience in providing education to clinical and non-clinical staff
Understanding of RADV and audit processes,
Detailed knowledge and understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems
Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical specifications
Knowledge of HIPAA requirements, anatomy and physiology
Proficient in MS Word, Excel, PowerPoint and Outlook
Ability to work effectively with common office software, coding software, and EMR systems
Bachelor’s degree (healthcare or relevant field) or equivalent experience/training

Preferred:

Six or more years of clinic or IPA and/or managed care experience
Knowledge of Medicare Advantage billing/claims submission and other related actions
Ability to work effectively with common office software, coding software, and EMR systems
Registered Nurse (RN) or clinical qualifications

Note: Skills may be subject to test.

Apply Now

Refine Your Search

risk adjustment jobs in los angeles, ca

Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid)

Risk Adjustment Registered Nurse (RN)

Senior Manager, Risk Adjustment

HCC Coding Specialist

Strategy & Operations Associate - Insurance Solutions

Medical Records Specialist (Agency Temp)

Clinical Social Worker

Manager, Compliance

Licensed Clinical Social Worker-Hybrid

Ecommerce Manager

BCBA Consultant

EPL & D&O Liability Claim Counsel

Clinical Quality Improvement RN

Division Credit Manager - Consumer, SBA, Business Banking, Card

MACHINE MAINTENANCE TECHNICIAN III

Assistant Operations Manager

Social Work Educator

Operations Manager-3rd shift

Quality Control Technician, 2nd Shift

Heavy-Civil Project Manager

I want to receive the latest job alert for risk adjustment in los angeles, ca

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