87 (CRC) Certified Risk Adjustment Coder jobs

CenterWell Senior Primary Care is seeking a Medical Coding Coordinator 1 to extract clinical data from medical records and assign CPT, HCPCS, and ICD codes. This role includes DRG verification and routine database tasks, with responsibilities performed under close supervision and within established guidelines. The position is not remote and requires high school completion plus CPC/CCS/CRC credentials and at least two years of coding experience. #J-18808-Ljbffr

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via...

Job Description Job Description Position Summary The HCC Coder will be responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted and established standards. The HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services. Schedule: Full-time (Non-Exempt) Flexible, may require some evening and weekends Primary Duties and Responsibilities Review of medical records to ensure accuracy and claims for proper documentation and coding and completeness. Communicate with providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes. Create training presentations to educate staff in Medicare...

Job Title Risk Coder Location Virginia Beach, VA Work Shift First (Days) Job Description Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs...

Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do: Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other departments to address coding updates and support risk...

Location: Newark, New Jersey, United StatesCompany: AxelonPosted: 2026-08-19Axelon Services Corporation is seeking a skilled medical coder in Newark, NJ. This role involves reviewing and analyzing medical record documentation for accuracy and compliance with ICD-9/ICD-10 guidelines.Applicants should possess RHIT certification or similar credentials along with at least two years of experience in medical coding. Strong knowledge of coding systems and excellent communication skills are essential. Join a team focused on continuous improvement and quality assurance in healthcare documentation.#J-18808-Ljbffr

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

A healthcare provider in Knoxville is seeking a full-time Certified Medical Coder. The position requires thorough clinical documentation reviews and accurate coding of HCC diagnoses using ICD-10-CM guidelines. Candidates must have current CPC or RHIT certification, be team players with strong communication skills, and maintain HIPAA privacy. This remote role involves occasional onsite meetings, making it crucial for candidates to reside in the Knoxville area. #J-18808-Ljbffr

CorroHealth Inc is seeking Risk Adjustment Coding Specialists to join the HCC Coding Team. This role involves reviewing medical records to abstract codes following Medicare and specific client requirements. The position is remote, part-time with flexible hours after meeting productivity goals. Qualified candidates should have recent HCC coding experience, a valid coding credential, and excellent communication skills. Responsibilities include coding records and maintaining high quality standards. #J-18808-Ljbffr

Seeking HCC Coders for a remote Coding Project. MUST HAVE HUMANA EXPERIENCE $21-$23 hr Responsibilities Ability to review medical records for accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial and Medicaid risk adjustment from various chart types (physician, facility, and non-facility). May have special projects that will entail a full coding review. Ability to code following the ICD-10-CM Official Guidelines for Coding and Reporting, AHA's Coding Clinic and well as Cotiviti and client specific coding guidelines. Intermediate skills and knowledge of computers with the ability to use the designated coding platform for coding processes with focus on both production and accuracy. Ability to regularly and consistently achieve over 95% quality accuracy. Appropriately communicate with management regarding workload, production expectations and deliverables. Utilizes the 'Dispute Resolution' process when disagreement occurs related...

Prominence Health is seeking a Senior Coder responsible for documentation and coding review of medical records at partnered medical practices. This role involves working with provider offices to ensure accurate reporting of diagnoses and service codes. The position may require occasional onsite work and travel for provider education. Qualified candidates should have 3+ years of experience in CMS coding and certification, with the ability to communicate effectively and work independently in a #J-18808-Ljbffr

Cano Health in Florida is seeking a Risk Adjustment Coder to identify, review, and document CMS HCC related diagnoses. You will verify the accuracy, completeness, specificity, and appropriateness of coding based on services rendered, and provide essential support to justify recommendations. Travel to offices for on-site chart reviews may be required. Required are two plus years of medical coding experience, CPC/CPC-A/CCS-P/CRC certifications, and proficiency with Word and Excel. #J-18808-Ljbffr

Prominence Health is seeking a Senior Coder to perform documentation and coding reviews for services rendered across partnered practices. You will ensure accurate diagnoses and service codes to support risk adjustment and quality measurement, with pre, post, and wraparound input. Some onsite work and occasional travel may be involved. Strong CMS coding knowledge, HCC experience, and EMR proficiency are essential. Bilingual Spanish is a plus, and CRC/AHIMA credentials are preferred. #J-18808-Ljbffr

TEKsystems is seeking a Senior Risk Adjustment/Coding Specialist to evaluate and ensure accuracy of risk adjustment reporting. The role involves reviewing both inpatient and outpatient records, ensuring CMS/HCC alignment, and protecting patient privacy under HIPAA. This contract position is based out of Jacksonville, FL, but offers full remote work. Ideal candidates have 7+ years in risk adjustment coding, CRC certification, and strong MS Office skills. #J-18808-Ljbffr

Position Summary About Orlando Health At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida's east to west coasts and beyond. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. "Orlando Health Is...

## Risk Adjustment CoderApplyremote type: Hybridlocations: Jupiter, FLtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR4147It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.**Job Summary**The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.**Duties & Responsibilities****Essential Duties & Responsibilities*** Review medical record information to identify all appropriate coding...