268 (CRC) Certified Risk Adjustment Coder jobs

Covenant HealthCare is seeking a Risk Adjustment Coding Specialist to ensure accurate documentation and coding for HCC performance across CHP providers. You will educate primary and specialty care teams, review charts, and support analytics to improve coding accuracy and revenue capture. The role emphasizes collaboration with physicians, auditors, and CHP leadership, with opportunities to lead educational initiatives and stay current on coding updates. #J-18808-Ljbffr

Job Description Job Description Overview This is a temporary position for approximately 6 months. Responsibilities The Risk Adjustment Coder is responsible for providing support to the Risk Adjustment Department. This position will work closely with the VBC Risk Director, Program Managers, (Nurse Practitoners) NPs and external vendors to assist with managing the Chronic Disease Managed Visit (CDMV) Program through coding charts and queries.     Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.   Collaborate with Lead Coder to review CDMV progress notes and CDMV Summary Continuous streamlined communication with NPs on queries as needed Weekly meeting with Lead coder to discuss any barriers on receiving responses to queries or any questions regarding coding Stay up to dates with CMS Coding Guidelines as identified for Risk Adjustment (CPT and ICD codes) Collaborate with coordinators and specialists for adhoc...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

Porter Cares, Inc. is hiring a Risk Adjustment Coder to improve coding accuracy and facilitate effective in-home health assessments. The ideal candidate will possess a CPC or CSS certification and have a minimum of 5 years of risk adjustment coding experience. Responsibilities include coding assignments, managing documentation accuracy, and supporting coding education initiatives. The position offers a competitive wage between $50,000 - $54,000 annually with opportunities for professional growth. #J-18808-Ljbffr

Cano Health in Miami is seeking a Risk Adjustment Coder to identify, extract and document diagnoses for CMS HCCs. You will review medical records, ensure accuracy of codes and coordinate with PCPs for MRA coding and quality initiatives. The role requires CPC or CCS-P/CPC-A certification and 2 years of medical coding experience, strong Excel skills, attention to detail, and solid communication. Travel to offices for on-site chart reviews may be required. #J-18808-Ljbffr

## Risk Adjustment Coder IIIApply: Hybrid: Miami, FL: Full time: Posted 2 Days Ago: JR4418It'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 III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.**Duties & Responsibilities****Essential Duties & Responsibilities*** **Medical Coding and Documentation*** Assign ICD-10-CM diagnosis codes based on medical...

Millennium Physician Group in Indiana is seeking a Risk Adjustment Coding Specialist II to review patient records after visits and translate documentation into provider-selected ICD-10-CM codes for claims processing. You will collaborate with the MRA Department to validate codes to the highest specificity, identify missing information, and maintain professional certifications while ensuring HIPAA compliance and timely submissions. #J-18808-Ljbffr

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating and...

Cano Health in Miami, FL is seeking a Risk Adjustment Coder III to join our hybrid team. You will assign ICD-10-CM codes, review charts, and ensure accurate HCC capture in line with CMS guidelines. The role requires meticulous documentation and collaboration with clinical staff to support patient care analytics. We expect at least 5 years of medical coding experience with a CPC or CCS certification. Strong analytical and communication skills are essential, and you will participate in audits #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...

HCC Coding Auditor Senior - Health Plan NetworkUS:TX:Irving | Revenue Cycle Audit | Full TimeHCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and 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, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option.Responsibilities:Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion,...

Now Hiring: HCC Coder with CRC Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote PRN HCC Coder with CRC to join our team. Location Address: Remote Office Santa Fe, NM 87501 Compensation Pay Range: Minimum Offer $24.27 Maximum Offer $41.33 Type of Opportunity: Full time 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 Some key responsibilities include: Reviews patients entire current medical record, assigning appropriate...

Presbyterian Healthcare Services in New Mexico is seeking a Remote HCC Coder with CRC to join our team. This full-time, non-exempt position supports coding across inpatient, outpatient, ER, home health, and professional services to ensure accurate reimbursement and compliance. The ideal candidate will hold a coding credential (HCS-D, CCS, CCS-P, CPC-H or CPC, or RHIT/RHIA), have 1–3 years of experience, and be proficient with CPT/ICD coding, Word, Excel, PowerPoint, and EMR systems. #J-18808-Ljbffr

## Provider Educator & Medicare Risk Adjustment Coder (W@H SC, NC, GA, TN, FL)Apply: Remote: W@H South Carolina: Full time: Posted Today: End Date: November 12, 2026 (14 days left to apply): R1052585# **Summary**Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! We are currently hiring for a Provider Educator...

Support the risk and quality team, IPA Administrators, and the VP of Operations on Clinical Initiatives to improve patient outcomes and group quality measures in Risk Adjustment, CMS 5 Star, and the commercial and Medi-Cal programs. Principal Duties and Responsibilities (* = essential functions): Outreach and coordinate care for IPA members who need preventative and/or chronic care services such as mammograms, colonoscopies, uncontrolled HbA1c, uncontrolled blood pressure, etc. Collaborate with Risk Adjustment and quality on provider education. Maintain knowledge of clinical initiatives and risk adjustment program requirements Maintain knowledge of 5 Star performance and risk adjustment factors for all IPAs. Collaborate with health plans on 5 Star, commercial, and Medi-Cal gap reports. Coordinate outreach to PCP offices on member due reports, including the No Annual Visits list. Provide PCP offices with ongoing education on quality measures Work with health...

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding. You will review medical records to assign ICD-10-CM codes supporting risk adjustment and HCC reporting. Ideal candidates have strong medical record review and coding compliance experience, and familiarity with CMS guidelines. Work with providers and clinical teams to improve documentation accuracy and coding quality. #J-18808-Ljbffr

Join Carina Health NetworkHelp us make Colorado communities healthier!Are you passionate about population health and interested in improving patient experience and outcomes? If so, we support several community health organizations (CHO), and this company is for you!At Carina Health Network, we are transforming community health by delivering proactive, data-informed, and whole-person care that drives measurable impact. Our work helps people stay healthier longer, by supporting community health organizations who have patients with chronic conditions like diabetes and high blood pressure, ensuring regular check-ups for older adults, and identifying mental health needs early. We help community health organizations prevent costly ER visits by connecting people with the right care at the right time. Through our value-based care programs, we empower frontline care teams to improve outcomes while earning fair, sustainable reimbursement. By saving money and reinvesting in community...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

Job Description Job Description *Hybrid Role, must be located in State of Colorado* Join Carina Health Network and help us make Colorado communities healthier! Are you passionate about population health and interested in improving patient experience and outcomes? If so, we support several community health organizations (CHO), and this company is for you! At Carina Health Network, we are transforming community health by delivering proactive, data-informed, and whole-person care that drives measurable impact. Our work helps people stay healthier longer, by supporting community health organizations who have patients with chronic conditions like diabetes and high blood pressure, ensuring regular check-ups for older adults, and identifying mental health needs early. We help community health organizations prevent costly ER visits by connecting people with the right care at the right time. Through our value-based care programs, we empower frontline care teams to improve...

Clinical Risk Adjustment Coder Alpine Physician Partners partners with independent physician groups to deliver coordinated, value-based care that improves outcomes and lowers the total cost of care. Our clinical and coding teams support providers with the accurate, compliant documentation and coding practices that make value-based care possible. The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. Review medical records, encounter notes, and provider documentation to identify and validate diagnosis codes relevant to HCC and other risk adjustment models. Conduct in-home or virtual health assessments with patients, evaluating...