130 (CRC) Certified Risk Adjustment Coder jobs

Job Details Physician Office | Kettering | Full-Time | First Shift Responsibilities & Requirements This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the ambulatory records for the appropriate risk adjustment components Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements...

Description: Join the Team at PedIM Healthcare! Delivering exceptional care, together. Who We Are PedIM Healthcare is the first private medical office of its kind in Citrus County offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, womens care, medical weight-loss, sleep-medicine services and more. Our dedicated, community-focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County. Why Work With Us? A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight-loss & sleep medicine specialties. A values-driven environment: we listen, we help, we understandand we care. Community-oriented and recognized: voted best of the best in the region. Opportunity to make a meaningful impact by supporting patients over their full life spanfrom...

Job Description Job Description 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...

## CMS HCC Coder - Hybrid remote - Orange, CA.Applyremote type: Hybrid Remotelocations: Orange, CAtime type: Full timeposted on: Posted Yesterdayjob requisition id: R2056Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.This position is hybrid- remote in Orange, CA. The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor...

Description: Join the Team at PedIM Healthcare! Delivering exceptional care, together. Who We Are PedIM Healthcare is the first private medical office of its kind in Citrus County offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, womens care, medical weight-loss, sleep-medicine services and more. Our dedicated, community-focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County. Why Work With Us? A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight-loss & sleep medicine specialties. A values-driven environment: we listen, we help, we understandand we care. Community-oriented and recognized: voted best of the best in the region. Opportunity to make a meaningful impact by supporting patients over their full life spanfrom...

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 with ICD-10-CM Guidelines for Coding and Reporting. The diagnosis codes for each chronic or major medical condition have been captured correctly. Any diagnosis code that is unsubstantiated by the record should be queried to provider and assessed for accuracy. Reviews for clinical indicators and queries providers to capture the severity of illness of the patient. Conducts medical charts to identify opportunities for improving individual member risk adjustment score accuracy. Provides feedback to...

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

The Downtown Boulder Partnership is seeking a Risk Adjustment Coder to join their team in Lakeland, Florida. This role involves conducting coding audits and ensuring adherence to compliance standards. Ideal candidates will have over 10 years of experience in coding, strong knowledge of ICD-10 and CPT codes, and relevant certifications such as CPC or CCS. The position offers a structured work environment from Monday to Friday. The selected candidate will have opportunities for continued training and responsibility in a collaborative healthcare setting. #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

A leading healthcare provider in Fort Myers is seeking a Certified Medical Coder to join their Compliance and Coding department. This in-house position requires strong knowledge of ICD-10, CPT, and HCPCS coding guidelines, with an emphasis on HCC Risk Adjustment coding. The role demands a detail-oriented professional who can work independently while supporting providers and ensuring compliance. Enjoy a supportive work environment with opportunities for professional growth and competitive benefits including health insurance and paid time off. #J-18808-Ljbffr

It'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 SummaryThe 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 & ResponsibilitiesEssential Duties & ResponsibilitiesReview medical record information to identify all appropriate coding based on CMS HCC categoriesPrepare the medical charts and track patient information via Excel spreadsheets.Complete appropriate paperwork/documentation/system...

AAPC is seeking a remote Coding Specialist to validate ICD-10-CM codes for PACE Risk Adjustment. The ideal candidate has at least 3 years of PACE risk adjustment coding experience and CRC certification. You will be responsible for meeting production standards and preparing reports while upholding the confidentiality of protected health information. Successful candidates are detail-oriented, excellent communicators, and possess strong computer skills. AAPC offers an inclusive work culture where teamwork and growth are supported. #J-18808-Ljbffr

## Certified Risk Adjustment CoderApplylocations: Hialeah, FLtime type: Full timeposted on: Posted Todayjob requisition id: JR102682**As Mount Sinai grows, so does our legacy in high-quality health care.**Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.**Culture of Caring: The Sinai Way**Our hardworking,...

Gather Health is seeking a Risk Adjustment Coding Specialist to support accurate diagnosis documentation as part of its value-based care initiatives. This role plays a crucial part in ensuring compliance with coding practices and enhancing quality outcomes under Medicare Advantage contracts. The ideal candidate has at least two years of professional coding experience, living in the Boston area. Benefits include comprehensive health insurance, retirement plans, and generous PTO. #J-18808-Ljbffr

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and employer of choice! Will you join us, to help achieve our higher purpose? What Makes Us Unique We are an empowered primary care...

Gather Health Gather Health Primary Care, Inc. in Boston is seeking a Risk Adjustment Coding Specialist to ensure accurate coding practices that align with Medicare Advantage regulations. This role involves collaborating with a clinical team to improve patient outcomes through meticulous documentation. The ideal candidate should have a strong background in coding with at least two years of experience, preferably with risk adjustment. Gather Health offers comprehensive benefits including medical, dental, and vision coverage starting on day one. #J-18808-Ljbffr

Mount Sinai Medical Center of Florida, Inc. is seeking a Certified Risk Adjustment Coder to ensure accurate coding and documentation standards. The role involves reviewing medical records, providing feedback to physicians, and maintaining coding credentials. The ideal candidate will have at least five years of experience in coding and billing, with a strong knowledge of ICD-10-CM and CPT. Benefits include health insurance, paid time off, and tuition reimbursement. #J-18808-Ljbffr

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $26.00/hr - $27.00/hr Direct message the job poster from Insight Global Professional Recruiter at Insight Global We are looking for a full-time REMOTE HCC/Risk Adjustment Medical Coder for a contract up to 12 months with possible extensions or conversions. Must hold an active CPC or CCS, as well as 3+ years of HCC/risk adjustment coding experience. ****The pay rate is $25-26.50 per hour depending on experience**** Job Summary: Insight Global is hiring HCC/Risk Adjustment Medical coders to support a backlog for inpatient and outpatient Medicare Advantage projects. Candidates must obtain an active Coding certification (CPC) through AAPC or AHIMA. The role primarily involves risk adjustment coding, focusing on HCC ICD-10 codes. Experience with problem list coding is a plus but not required. Responsibilities include validating...

AAPC is looking for a remote contractor skilled in medical coding, specifically in validating ICD-10-CM codes for PACE Risk Adjustment. The ideal candidate will have at least 3 years of experience in this field and possess strong Excel skills for reporting purposes. The role requires excellent communication skills, critical thinking, and an ability to manage time effectively. You will be held accountable for the confidentiality of protected health information and will collaborate within a supportive team-oriented environment. #J-18808-Ljbffr