(CRC) Certified Risk Adjustment Coder jobs

Full Time

C2Q Health Solutions Hybrid (NY)

JOB PURPOSE: Responsible for supervising, evaluating, and consistently improving the day-to-day operations of Medical Practice. This role is responsible for accurate and timely billing of insurance claims and patient statements across multiple sites, implements accurate medical coding policies, and enhances operational processes. It involves acting as a liaison between coding operations and clinical staff, training and coaching medical personnel on coding guidelines, and ensuring the accuracy and timeliness of clinical documentation. Additionally, the role includes analyzing and optimizing diagnosis data submission processes, presenting performance results to leadership, and supporting HCC/RAF optimization strategies. The role will also oversee the training of Medical Practice Assistants, Physician and IDT disciplines in ICD-9/ICD-10 guidelines. JOB RESPONSIBILITIES: Responsible to deliver accurate and timely billing of insurance claims and patient statements for all...

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HCC Coder

U Mass Memorial Health Worcester, MA

Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $25.83 - $43.91 Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations . Schedule Details: Monday through Friday Scheduled Hours: 7:00am-3;30pm Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can...

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HCC Risk Coder

Pathways Health Partners Leesburg, FL

Description Welcome to Pathways Health Partners, the Accountable Care Organization (ACO) that's leading the charge in helping independent providers transition to Value-Based Care. What We Do: Medicare REACH ACO: We're at the forefront of Medicare innovation. Medicare Advantage MSO: Providing top-notch services to our Medicare Advantage patients. Commercial MSO: Managing care for approximately 16,000 patients across North-West/Central Florida. Where We Operate: From The Villages to St. Petersburg, and across to Mount Dora, we've got you covered! Our Services: Hospital Medicine Group: Delivering exceptional care in hospitals. Affiliated Medical Practices: Managing several top-tier medical practices. Insurance Agency: Offering comprehensive insurance solutions. Join us on our journey to better health and value-based care! Job Summary The HCC Risk Coder plays a vital role in coordinating and supporting retrospective and concurrent chart reviews while...

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Remote HCC Coder with CRC

Virtual Vocations Inc United States

A company is looking for a Remote PRN HCC Coder with CRC. Key Responsibilities Codes inpatient and outpatient medical records using ICD-9/10 CM and CPT-4 classification systems Abstracts data for quality improvement and compliance with regulations Resolves pre-bill edits and maintains up-to-date knowledge of coding regulations Required Qualifications High school diploma or GED required Certification in coding (HCS-D, CCS, CCS-P, CPC-H, CPC, or RHIT/RHIA) required at hire One to three years of coding experience required Computer skills in Word, Excel, and PowerPoint required Experience with an encoder and Electronic Medical Records preferred

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Certified Professional Coder – CPC, CRC

Tandigm Health Philadelphia, PA

Overview Certified Professional Coder – CPC, CRC Experience: 0 - 2 Years Responsibilities Responsible for serving as a key resource for medical coding matters. Performs reviews and audits and codes medical records to ensure the appropriate diagnostic codes and modifiers are used per Generally Accepted Medical Coding Guidelines, ICD-10 Guidelines and the CMS National Correct Coding Initiative. Participates in the implementation of the organization’s Coding Proficiency program. Interfaces and disseminates audit results to clinicians and management and provides guidance to practices on improving medical coding accuracy. Consistently exhibits behavior and communication skills that demonstrate Tandigm’s commitment to superior customer service, including quality, care and concern with each internal and external customer. Performs review of encounter notes for accuracy of ICD-10 and CPT codes prior to billing submission. Addresses coding and documentation discrepancies prior to billing...

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Remote Risk Adjustment Coder | CMS HCC Specialist

CommonSpirit Health Bakersfield, CA

A healthcare organization is seeking a Coder to translate medical records into standardized codes and improve clinical documentation. This remote position requires an Associates degree and coding certifications. Key responsibilities include ensuring compliance with guidelines, educating providers, and safeguarding confidentiality of health information. Candidates should have expertise in CPT and ICD-10 coding and strong communication skills. A competitive pay range is offered alongside comprehensive benefits. #J-18808-Ljbffr

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Risk Adjustment Coder

CommonSpirit Health Bakersfield, CA

Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review network coding opportunities as it pertains to risk adjustment. Ensure that the diagnosis codes for each chronic or...

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Remote Risk Adjustment Coder - HIPAA-Compliant, CPC/RHIT

UNIVERSITY PHYSICIANS ASSOC INC. Knoxville, TN

A healthcare organization is seeking a full-time Certified Medical Coder based in Knoxville, TN. This remote role involves detailed clinical documentation reviews and accurate coding of HCC diagnoses. Candidates must have current CPC or RHIT certification and ideally two years of experience in an ambulatory care setting. Responsibilities include collaborating with healthcare providers, maintaining HIPAA guidelines, and educating staff on coding practices. The position is ideal for organized team players with strong communication skills. #J-18808-Ljbffr

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Certified Risk Adjustment Coder (CRC), Senior Associate

Ankura Washington, DC

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

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Remote Senior Risk Adjustment Coder - HCC/RADV Expert

Ankura Washington, DC

A leading consulting firm seeks a Sr. Associate to join its Health Care team in Washington, D.C. This position involves coding, compliance analysis, and project management for investigations and disputes in the health care sector. Ideal candidates will possess strong clinical knowledge and a CRC certification, with at least five years of relevant experience. The role allows for remote work and requires excellent communication skills. Salary range is between $85,000 and $200,000, commensurate with experience and other factors. #J-18808-Ljbffr

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Risk Adjustment Coder Specialist

Oscar Health Atlanta, GA

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be...

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Risk Adjustment Coder Specialist

Oscar Health Dallas, TX

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be...

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HCC Risk Adjustment Coder, Sr.

Regal Medical Group Los Angeles, CA

We are looking for experienced HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and...

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REMOTE Risk Adjustment Coder (6-month contract)

Sanford Barrows Group New York, NY

REMOTE Risk Adjustment Coder (6-month contract) The Risk Adjustment Coder works in a collaborative effort directly with physicians and their office staff and other support departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major focus of the position is to collect and review documents to support the organization’s quality and risk adjustment initiatives, which results in improving quality of care. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment Reviews of medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify whether: The diagnosis codes are supported by the documentation and ensure...

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Remote Senior Risk Adjustment Coder - HCC/RADV Expert

Ankura Chicago, IL

A consulting company is searching for a Sr. Associate with expertise in coding, revenue cycle, and clinical operations. This role focuses on complex investigations, compliance evaluation, and project management within healthcare disputes. The ideal candidate must be CRC certified with a strong grasp of clinical terminology and health regulations. Excellent communication skills and proficiency in Excel, Word, and PowerPoint are essential. The position offers a salary range from $85,000 to $200,000, depending on experience and location. #J-18808-Ljbffr

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Certified Risk Adjustment Coder (CRC), Senior Associate

Ankura Chicago, IL

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

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Remote Risk Adjustment Coder (CPC/CRC/RHIT/RHIA)

Village Center for Care, Inc. New York, NY

A community-based healthcare organization is looking for a Full Time Risk Adjustment Coder, offering a remote work option for residents of NY/NJ/CT. The role requires strong coding skills with a focus on ICD and CPT codes, ensuring compliance with regulations. Applicants must have relevant certifications and a commitment to healthcare quality improvement, with a competitive salary ranging from $77,506.87 to $87,195.23 annually. Employees enjoy various benefits including paid time off and education reimbursement. #J-18808-Ljbffr

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Certified HCC Coder

Virtual Vocations Inc United States

A company is looking for an HCC Certified Coder. Key Responsibilities Perform coding for patient health assessments and conduct peer coding quality reviews Conduct prospective medical chart audits related to Hierarchical Condition Categories (HCC) Educate clinicians on coding opportunities and maintain compliance with CMS Risk Adjustment guidelines Required Qualifications High school diploma or GED required CPC, CRC, CCS, or CCS-P credentials required Minimum of three (3) years of experience in a Certified Coder role, including HCC coding experience Proficiency with Microsoft Office and Electronic Medical Records Experience in Medicare programs and regulations, including Risk Adjustment

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Texas Licensed HCC Coder

Virtual Vocations Inc United States

A company is looking for a temporary HCC Coder (CPC Certified). Key Responsibilities Perform HCC / Risk Adjustment coding reviews accurately and efficiently Apply ICD 10 CM and risk adjustment coding guidelines appropriately Review and code medical records using designated EMR platforms Required Qualifications Active CPC certification (AAPC) - Apprenticeship (CPC A) credentials are not accepted 1-2 years of HCC / Risk Adjustment coding experience Experience working with EMR systems Strong knowledge of ICD 10 CM coding guidelines Ability to work independently in a remote environment

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HCC Coder I

Virtual Vocations Inc United States

A company is looking for a Coder 1/HCC Risk Adjustment. Key Responsibilities Conducts accurate diagnosis code abstraction for Medicare, Commercial, and Medicaid risk adjustment programs Stays updated on coding guidelines through required trainings and personal research Communicates findings and suggestions to Team Lead to improve department operations Required Qualifications Minimum High School Diploma Nationally certified coder in good standing through AAPC or AHIMA (e.g., CRC, CPC, CCS) 1-2 years of experience in medical risk adjustment/HCC coding Strong knowledge of medical terminology and anatomy Intermediate computer skills for coding processes

76 (CRC) Certified Risk Adjustment Coder jobs