104 (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...

Hcc Coder Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered. Travel to provider office location/offices for HCC education as determined by manager Mandatory on-site team meetings in Midland 1 x per month To be part of our organization, every employee should understand and share in the MyMichigan Health Vision, support our Mission, and live our Values. These values include excellence, integrity, teamwork, and accountability must guide what we do, as individuals and professionals. The HCC Coder, working under the direction of the Clinical Documentation Integrity Manager, utilizes coding expertise to identify areas of opportunity that impacts the quality and the completeness of the medical record documentation. Through prospective, concurrent, and retrospective evaluation of the medical record documentation, the HCC Coder will be responsible for working collaboratively with the clinical team members to...

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...

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...

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

Location Address: Remote Office Santa Fe, NM 87501 Compensation Pay Range: Minimum Offer $21.70, Maximum Offer $33.14 Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote PRN HCC Coder with CRC to join our team. Type of Opportunity: PRN. Job Exempt: No. Job is based: Remote Workers. New Mexico. Work Shift: Varied Days and Hours (United States of America). Responsibilities Codes more than one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Ensures adherence to Hospital and Departmental Policies and Procedures. Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS...

Presbyterian Healthcare Services in Santa Fe is looking for a skilled Remote PRN HCC Coder with CRC to join their team. This position involves coding inpatient and outpatient records, ensuring compliance with regulations, and maintaining high accuracy and productivity standards. Candidates must have a high school diploma, relevant coding certifications, and 1-3 years of coding experience. A comprehensive benefits package is offered, including medical, dental, and vision coverage, as well as disability insurance. #J-18808-Ljbffr

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...

A health care advisory firm is seeking a Sr. Associate to analyze medical records and ensure compliance with coding standards. The ideal candidate will be certified in Risk Adjustment Coding and have at least five years of experience in HCC/Risk Adjustment methodologies. Strong communication skills and proficiency in Excel are essential. This role offers a hybrid work environment. Salary range is between $85,000 to $200,000 based on qualifications and experience. #J-18808-Ljbffr

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

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

A leading consulting firm in Washington, DC seeks a Sr. Associate specialized in healthcare coding and compliance. The role involves analyzing patient records, ensuring coding guidelines adherence, and managing complex investigations. Candidates must have a CRC certification and strong communication skills, with the ability to work independently. The position offers a competitive salary range between $85,000 and $200,000, depending on experience, and focuses on maintaining high quality in a fast-paced environment. #J-18808-Ljbffr

Medical Risk Adjustment Coder (Remote) Location: Remote (Must reside within the Continental United States) Position Type: Full-Time, 40 hours per week Schedule: Monday – Friday, 8-hour daytime schedule tailored to your local time zone Training Hours: Monday – Friday, 8:00 AM – 5:00 PM ET (Attendance is mandatory) Position Overview This home-based position is designed for a detail-oriented, certified medical coder responsible for reviewing medical records to ensure accurate, compliant, and complete diagnosis code abstraction. Aligned with strict productivity and quality requirements, this role focuses on Medicare, Commercial, and Medicaid risk adjustment across various chart types (physician, facility, and non-facility). The successful candidate will thrive in a fast-paced environment, maintaining high quality while executing general coding workflows and specialized review projects. Key Responsibilities Code Abstraction & Quality Assurance Diagnosis Code Abstraction: Review...

HCC Auditor (Humana Experience Required) – Contract (3–6 Months) We are seeking experienced HCC Auditors with Humana experience to support a HCC coding project. This contract assignment will run approximately 3–6 months with full‑time hours (minimum 40 hours per week). Role Overview The Auditor Specialist will perform quality assurance reviews on coded medical charts according to client‑specific guidelines. This role requires strong accuracy, adaptability, and the ability to work independently in a fast‑paced remote environment. Key Responsibilities Audit coded charts assigned by the Quality Supervisor following client‑specific guidelines Navigate multiple client guideline sets with minimal difficulty Maintain 95%+ accuracy at the diagnosis level Respond to rebuttals submitted by coders or auditors Participate in weekly project review meetings Complete additional tasks as assigned by the Quality Project Manager Required Qualifications Humana experience is required High school...

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...

A healthcare technology company is seeking a Coding Associate responsible for delivering high-quality risk adjustment coding services for clients. This role requires reviewing medical records, assigning diagnosis codes, and ensuring compliance with CMS standards. Required qualifications include relevant certifications and 1-2 years of medical coding experience. The position offers a competitive salary package, comprehensive benefits, and opportunities for professional growth. This is a fully remote role based in the United States. #J-18808-Ljbffr

Allmed Staffing Inc is seeking a Certified Medical Coder for a full-time remote role. The ideal candidate will be responsible for the accurate coding of medical services across various settings. This position requires a high school diploma or GED, along with 3+ years of coding experience and active certification from AAPC or AHIMA. Strong experience in CMS HCC Risk Adjustment Models is essential, along with advanced coding knowledge. #J-18808-Ljbffr

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

A national recruitment agency is looking for experienced HCC Medical Coders for a fully remote position. The role involves reviewing medical charts, assigning ICD-10 codes for risk adjustment, and ensuring compliance with coding standards. Candidates should have at least 2 years of coding experience and be proficient in meeting accuracy and productivity standards. This contract offers a pay rate of $27/hour with specified training and working hours. #J-18808-Ljbffr

Village Practice Management Company, LLC (VillageMD) is seeking a full-time Texas Licensed Clinical Coder to work in a remote environment. This role involves reviewing, analyzing, and coding diagnostic information in patient charts while ensuring compliance with established coding guidelines and identifying opportunities for improved accuracy. The ideal candidate will possess a professional coding certification and at least one year of experience in advanced professional coding, particularly with HCC coding. Proficiency with Electronic Health Records and Microsoft Office applications is essential. #J-18808-Ljbffr