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Online Resumes with "HCC Risk "



Health Plan / Provider Network Management

Highly organized and experienced managed care business professional with accomplished track record of success in managing the delivery of sound operational and customer service to employer groups, providers, and patients. Experienced in provider network management with network development and expansion, project management and operational expertise in oversight of commercial and government programs including Original Medicar...

Tags for this Online Resume: Network Operations Management, Health Plan Network Development and Expansion, Provider Education and Training, Provider Communications and Manuals, Leadership / Team Collaboration, Credentialing / Re-Credentialing, Claims Troubleshooting, TeleHealth Development

Regional Manager in Managed Care - 15 years Experience - Denver Area

Over 15 years experience in the Healthcare industry, in the areas of Managed Care, HCC/Risk Adjustment, coding, claims auditing, project management/software implementation, EDPS, compliance, claims / encounters and reimbursement.

Tags for this Online Resume: medicare advantage, HCC RISK ADJUSTMENT, Analyst, Audit, Management, Forecasting, Auditing Projects, Documentation, Medical, SQL

Vice President - 11 Years of Experience - Near 85737

RESUME SUMMARY An innovative, customer oriented healthcare management professional with extensive experience in Medicare FFS, Medicare Advantage, managed Medicaid, ACA/Exchange and Workers' Compensation. A coaching leadership style with a strong background in account management/client services, provider contracting and network management, and sales. Specific areas of expertise include: * HCC Risk Adjustment * Encounters Rep...

Tags for this Online Resume: Management, Book of business, Leadership, Product Launch, Project Management, Account Management, Medicare, P&L, manager, management

Featured Profile

Medical or Health Services Manager - 20 Years of Experience - Near 32174

SUMMARY * 30 years in healthcare with thorough knowledge of ICD-10-CM, ICD-10-PCS and CPT coding for hospital and physician reimbursement, including Medicare and Medicaid regulations * Successful with hospital and physician coding and billing denials and appeals * Performed monthly MS DRG and APC audits and coding education internally * Successful appeals of MS DRG and APC denials from insurance companies * Successful devel...

Ideal Companies: Hospitals, colleges, university.

Tags for this Online Resume: Documentation, Management, Coding, Data Quality, Quality, Quality Assurance, Quality Management, CCS, Audit, Billing, coding, Health Information, Online Health Information Management Coding Jobs

Health Technologist - 19 Years of Experience - Near 92557

To obtain a job with a company who will allow my skills to be challenged

Tags for this Online Resume: Coding, Data Entry, Documentation, EMT, Email, Medical, Billing, Certificate Authority, Compliance, Microsoft PowerPoint