16 risk adjusted coder jobs found

How You’ll Make An Impact At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel right at home at Strive! Benefits & Perks Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support –...

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk) GENERAL SUMMARY Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned....

Brief Description: Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20+ acres just north of mid‑town Miami and houses support departments such as Finance, Accounting, Human Resources, Marketing, and more. Join us to do purposeful work with a diverse and respectful team. Job Title: HCC Risk Adjuster and Coder Job Summary: Reviews medical records and accurately codes and sequences diagnosis in order to obtain maximum reimbursement. Essential Job Functions Audit PACE medical records to ensure accuracy upon enrollment and disenrollment, and assign appropriate HCC codes per established department guidelines. Perform follow‑up coding of medical records resulting from internal and external reviews that identify coding discrepancies. Meet with PACE providers via MS Teams to assist with documentation improvement tied to reimbursement. Assist with other department duties as necessary....

Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20+ acres just north of mid‑town Miami, and is home to our support departments like Finance, Accounting, Human Resources, Marketing and more. Location: 5200 Northeast 2nd Avenue, Miami, FL, 33137, United States Employee Type: Full‑Time Contact Information: Miami Jewish Health Talent Team, Phone: 3057518626 Job Title HCC Risk Adjuster and Coder Job Summary Reviews medical records and accurately codes and sequences diagnosis in order to obtain maximum reimbursement. Essential Job Functions Audits PACE medical records to ensure accuracy, upon enrollment and disenrollment, and assigns appropriate HCC codes per established department guidelines Performs follow up coding of medical records as a result of internal and external reviews which identify coding discrepancies Meets with PACE providers via MS Teams to assist with...

Miami Jewish Health in Miami, FL is seeking an experienced HCC Risk Adjuster and Coder to review medical records, code diagnoses, and sequence codes to maximize reimbursement. The role requires an Associate degree in Health Information Management and at least 1 year of risk adjustment coding experience. You will audit records, collaborate via MS Teams with PACE providers, and support department duties in a fast-paced environment. #J-18808-Ljbffr

Brief Description: Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20+ acres just north of mid‑town Miami and houses support departments such as Finance, Accounting, Human Resources, Marketing, and more. Join us to do purposeful work with a diverse and respectful team. Job Title: HCC Risk Adjuster and Coder Job Summary: Reviews medical records and accurately codes and sequences diagnosis in order to obtain maximum reimbursement. Essential Job Functions Audit PACE medical records to ensure accuracy upon enrollment and disenrollment, and assign appropriate HCC codes per established department guidelines. Perform follow‑up coding of medical records resulting from internal and external reviews that identify coding discrepancies. Meet with PACE providers via MS Teams to assist with documentation improvement tied to reimbursement. Assist with other department duties as...

Miami Jewish Health is seeking an HCC Risk Adjuster and Coder to review medical records and accurately code and sequence diagnoses to maximize reimbursement. The role requires a minimum of 1 year of HCC/ ICD-10-CM coding experience, an associate degree in health information management, and strong knowledge of medical terminology. You will audit PACE records, interface with providers via MS Teams, and support documentation improvement while maintaining confidentiality and accuracy. #J-18808-Ljbffr

Miami Jewish Health in Miami, FL is seeking an experienced HCC Risk Adjuster and Coder to review medical records, code diagnoses, and sequence codes to maximize reimbursement. The role requires an Associate degree in Health Information Management and at least 1 year of risk adjustment coding experience. You will audit records, collaborate via MS Teams with PACE providers, and support department duties in a fast-paced environment. #J-18808-Ljbffr

Medical Coder I At ClareMedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At ClareMedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits welcome to ClareMedica. We are seeking an accurate, detailed oriented Coder to join our team. You will play a key role in reviewing...

The Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10‑PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR‑DRG) or Medical Severity Diagnosis Related Group (MS‑DRG) for optimal reimbursement. The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra’s coding policies. The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information. Responsibilities Assigns diagnosis and procedure codes. Verifies accuracy of DRG Accurately abstracts required information. Initiates provider coding...

JOB DESCRIPTION SUMMARYPosition reports to the Supervisor Benefit Distribution & Installation and performs in-depth pharmacy and medical plan coding of new and existing business accounts. This position will ensure that all new and existing health (medical/dental/pharmacy) insurance plans underwritten by Western Growers Assurance Trust (WGAT) and those of Pinnacle Claims Management, Inc. (PCMI) are in compliance with the respective employers’ summary plan descriptions.DUTIES AND RESPONSIBILITIESPlan CodingPlan code new business and plan changes.Verify new and existing plans loaded on the company’s claim management system against the appropriate Summary Plan Description to determine the accuracy of present and future claims payments.Respond to work orders received from examiners to investigate plan issues and irregularities.Evaluate testing requests for all new plans prior to loading them into the production system.AdministrativeKeep a detailed log of open and completed...

Certified Professional Coder- Medical Biller Certified Professional Coder- Medical Biller 2 days ago Be among the first 25 applicants Women's Health Connecticut provided pay range This range is provided by Women's Health Connecticut. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $27.00/hr - $29.00/hr Direct message the job poster from Women's Health Connecticut Talent Acquisition Specialist II at Women's Health Connecticut Women’s Health Connecticut is seeking to hire a Full-time, Certified Professional Coder (CPC)- Medical Biller at our corporate business office in Rocky Hill, CT. Position : Certified Professional Coder (CPC)- Medical Biller Location : Women's Health CT- HQ Working arrangement : Hybrid, 2-3 days per week in-office Employment Type : Full-time, 40 hours per week Schedule : Monday- Friday Reports to : Director of Revenue Cycle Management Position Summary: The CPC-Medical Biller is responsible for...

Position Status: Shift: Variable Less than 12 hour shift (United States of America) Hours per week: 0 Job Information Exemption Status: Non-Exempt A Brief Overview Reviews medical record documentation for assigning accurate ICD-10-CM diagnosis, procedure and CPT codes and chart abstracting for hospital related services, including "dual" medical coding, also known as Single Path Coding, for various specialties. Education Qualifications High School Diploma / GED Required Experience Qualifications 2 years Coding experience. Preferred Skills and Abilities Knowledge of medical terminology. (Required proficiency) Knowledge of coding and regulatory guidelines. (Required proficiency) Licenses and Certifications Registered Health Information Administrator (RHIA) - AHIMA Required or Registered Health Information Technician (RHIT) - AHIMA Required or Certified Coding Specialist - CCS Required or Certified Professional Coder - AAPC CPC also accepted. Required Certified Coding Associate -...

Medical Coding Specialist Reviews medical record documentation for assigning accurate ICD-10-CM diagnosis, procedure and CPT codes and chart abstracting for hospital related services, including "dual" medical coding, also known as Single Path Coding, for various specialties. Education Qualifications High School Diploma / GED Required Experience Qualifications 2 years Coding experience. Preferred Skills and Abilities Knowledge of medical terminology. (Required proficiency) Knowledge of coding and regulatory guidelines. (Required proficiency) Licenses and Certifications Registered Health Information Administrator (RHIA) - AHIMA Required or Registered Health Information Technician (RHIT) - AHIMA Required or Certified Coding Specialist - CCS Required or Certified Professional Coder - AAPC CPC also accepted. Required Certified Coding Associate - AHIMA CCA also accepted. Required What You Will Do Selects and assigns appropriate ICD-10-CM...

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...