12 Hedis Jobs

Gainwell Technologies LLC Summary Your role in our mission Essential Job Functions Assists in planning and designing business processes; assists in formulating recommendations to improve and support business activities. Assists in analyzing and documenting client's business requirements and processes; communicates these requirements to technical personnel by constructing basic conceptual data and process models, including data dictionaries and volume estimates. Assists in creating basic test scenarios to be used in testing the business applications in order to verify that client requirements are incorporated into the system design. Assists in developing and modifying systems requirements doc...

Immediate Job Openings for Certified HEDIS Medical Coders @ Vee Healthtek,Hyderabad Job Description: 1+ Years of Experience in Hedis Medical Coding. Specialty: Hedis Medical Coding Experience: 1 - 4 Years. Designation: Medical Coder/ Sr Coder/QA Certification: CPC/COC/CCS/CIC/CRC is Must Salary: 35K CTC Max Joining: Immediate Joiners only Location: Hyderabad - WFO Interested Candidate can Call Immediately to 9443238706 (Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh - HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek

Role & responsibilities PRINCIPLE JOB RESPONSIBILITIES: Accountable for all assigned personnel management activities, including overseeing the day-to-day operations of assigned team Accountable for the employment, timely performance evaluation, counselling, employee development, and discipline of assigned employees Accountable for management of assigned employees time keeping and PTO Conduct applicant interviews and screening Good understanding and ability to explain care management business processes Utilization Management, Disease Management, Case Management, Member Services and Appeals Good understanding and ability to explain Medicare and Medicaid business processes Establish and manage ...

As a Data Analyst with deep experience in the US Healthcare industry and skills around Machine Learning (ML), you will play a vital role in conducting comprehensive data analysis using statistical and exploratory methods to uncover patterns and insights that drive data-driven decision-making in the healthcare domain. Leveraging your knowledge of healthcare industry metrics such as HEDIS, CMS Star Ratings, risk adjustment models, and revenue cycle data, you will optimize analytics strategies to ensure efficient data quality, availability, and reliability for AI/ML-driven healthcare analytics solutions. Your responsibilities will include designing and maintaining data pipelines for the ingesti...

Job Title: Risk Adjustment Coder Location: Kolkata Job Type: Full-time Job Overview: Seeking skilled individuals for our medical coding team to conduct retrospective and concurrent chart reviews. Use HCC coding expertise to translate, input, extract, and validate medical data. Collaborate with Certified Risk Coders and Supervisors to ensure accurate diagnosis documentation and HCC abstraction through daily chart reviews. Responsibilities: Collaborate with Certified Risk Coders and Supervisors on daily chart reviews. Demonstrate strong ICD-10 coding knowledge. Follow client-specific guidelines and updates for chart coding. Exhibit strong qualitative and analytical skills. Possess knowledge of...

Roles and Responsibilities : Any graduate with minimum 1.2 years of experience in HCC Coding HEDIS experience candidates are preferrable Should have active coding credentials through AAPC/AHIMA is Mandatory Experience in HCC record abstraction and coding required Demonstrate high level of quality in clinical coding work, identifying and validating HCC mapped diagnoses that are revenue generating Adherence to official coding guidelines, coding clinic determinations, client specific coding guidelines, CMS and other regulatory compliance guidelines and mandates. Experience in medical record validation of correct coding procedures and guidelines Identified by accuracy of 95% or above and consist...

POSITION SUMMARY The Senior MD Analyst is responsible for supporting the development and design of clinical information systems and treatment protocols for the deployment of ZeOmega's Jiva platform. The role is responsible of abstraction, analysis and submission of clinical data. This position will work on the quality and coordination of data collection, entry, analysis, submission, report preparation, presentation of data, data sharing for process improvement initiatives, bench marking and outcomes research. This position communicates the report findings to others throughout the organization, including recommendations for improvements and focused studies. Works in partnership with ZeOmega l...

Cotiviti Hiring HCC Medical Coders For Coimbatore & Hyderabad for HEDIS Department: HCC Coding Role: Medical Coder / Sr Medical Coder Job Location: Coimbatore & Hyderabad Eligibility Criteria: Any graduate with minimum 1.2 years of experience in HCC Coding HEDIS experience candidates are preferrable Should have active coding credentials through AAPC/AHIMA is Mandatory Experience in HCC record abstraction and coding required Demonstrate high level of quality in clinical coding work, identifying and validating HCC mapped diagnoses that are revenue generating Adherence to official coding guidelines, coding clinic determinations, client specific coding guidelines, CMS and other regulatory compli...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities: Lead a team of 25-30 certified coders. Maintains staff by recruiting, selecting, orientin...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities Lead a team of 25-30 certified coders. Maintains staff by recruiting, selecting, orienting...

Role: Product Owner Product Owner Key Responsibilities: Define and communicate the product vision and strategy. Lead the product development lifecycle from ideation to launch, ensuring alignment with business goals and user needs. Collaborate with engineering teams to prioritize features and manage the product backlog effectively. Conduct research and competitive analysis to identify trends, opportunities, and potential areas for product enhancement. Engage with healthcare payers leaders, and regulatory bodies to gather insights and feedback on product performance and usability. Monitor and analyze product performance metrics to inform decision-making and drive continuous improvement. Foster...

Urgent Hiring: Python Developer -Rule Engine Company : Collance Technology Pvt Ltd. Collance Technologies , is a subsidiary of Care Connectors based in USA . We are into developing/Creating Saas based product for US healthcare domain Location : Noida Sector 62 Exp: 1-5 yrs Role: Develop and maintain a scalable Python-based rule engine, translate business rules into system logic, integrate with existing platforms, ensure performance, security, and maintainability. Key Skills: Strong Python, OOPs, Data Structures, Algorithms Frameworks: FastAPI, Flask, Pandas, JSON, Requests, PyUnit Experience with rule engine tools: Drools, IBM ODM, FICO Blaze, Camunda DMN SQL, REST APIs, AWS (S3, SQS, SNS, C...