guidelines. Validate clinical documentation to support appropriate risk adjustment coding, including Hierarchical Condition... to evaluate the effectiveness and compliance of risk adjustment quality programs. Provide expert guidance on CMS coding...
strategy, roadmap, and delivery of Medicare's risk adjustment models. This role requires a combination of healthcare clinical... the functional and technical roadmap for risk adjustment systems, including provider engagement tools, data / document...
policy to recommend appropriate actions Researches and prepares written appeals Exercises clinical and/or coding judgment... with CPT-4 coding, NCCI edit resolution and appropriate modifier use Advanced experience with regulations, compliance...
policy to recommend appropriate actions Researches and prepares written appeals Exercises clinical and/or coding judgment... with CPT-4 coding, NCCI edit resolution and appropriate modifier use Advanced experience with regulations, compliance...