38 jobs found

500618 Risk Adjustment Reno , NV Full Time - Eligible for Benefits Clerical & Administrative Support Day Posted 07/07/2025 7:30a-4pm Req # 184056 Remote Worker Salary: 22.16 - 31.03 Biweekly Hours: 80 Position Purpose The purpose of this position is to apply the appropriate diagnostic and procedure codes to individual patient health information for data retrieval, analysis, and claims processing for the health plan. Nature and Scope This position reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters covering a wide variety of clinical cases and services for risk adjustment models. This position is responsible for translating diagnostic phrases utilized by healthcare providers into coded form. The incumbent must have the skill sets to: * Select correct ICD code assignment by proficient analysis and translation of diagnostic statements, physicians' orders, and other pertinent documentation. * Critically evaluate...

Job Title: Remote HCC Coding Auditor Pay: $24.65 an hr | Bi-weekly Job Type: Remote Shift Options: Mon-Fri 8 am - 5 pm Remote HCC Coding Auditor Overview: The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews. The role focuses on ensuring accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS. Candidates must apply clinical documentation standards and industry guidelines to support coding decisions. This role contributes to audit accuracy, process improvements, and helps maintain compliance with state/federal regulations and internal policies. Remote HCC Coding Auditor Qualifications: 1. Proficiency in ICD-10-CM coding with strong understanding of HCC risk adjustment 2. Attention to detail and accuracy in retrospective chart reviews 3. Familiarity with CMS coding guidelines and HIPAA-compliant data handling...

Datavant is a data platform company and the worlds leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the worlds leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, youre stepping onto a high-performing, values-driven team. Together, were rising to the challenge of tackling some of healthcares most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring...

Datavant is a data platform company and the worlds leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the worlds leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, youre stepping onto a high-performing, values-driven team. Together, were rising to the challenge of tackling some of healthcares most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring...

Join to apply for the CRC Coding Auditor role at Conifer Health Solutions 21 hours ago Be among the first 25 applicants Join to apply for the CRC Coding Auditor role at Conifer Health Solutions Get AI-powered advice on this job and more exclusive features. Job Summary The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. Job Summary The CRC Auditor, conducts coding and...

Job Title: Remote HCC Coding Auditor Pay: $24.65 an hr | Bi-weekly Job Type: Remote Shift Options: Mon-Fri 8 am - 5 pm Remote HCC Coding Auditor Overview: The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews. The role focuses on ensuring accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS. Candidates must apply clinical documentation standards and industry guidelines to support coding decisions. This role contributes to audit accuracy, process improvements, and helps maintain compliance with state/federal regulations and internal policies.

Join to apply for the Risk Adjustment Coder I (EB/Solano) - 25-106 role at Hill Physicians Medical Group Continue with Google Continue with Google 1 month ago Be among the first 25 applicants Join to apply for the Risk Adjustment Coder I (EB/Solano) - 25-106 role at Hill Physicians Medical Group Get AI-powered advice on this job and more exclusive features. We’re delighted you’re considering joining us! At Hill Physicians Medical Group, we’re shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. We’re delighted you’re considering joining us! At Hill Physicians Medical Group, we’re shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members. Join Our Team! Hill Physicians has much to offer prospective employees. We’re regularly recognized as one of the “Best...

Job Title: Remote HCC Coding Auditor Pay: $24.65 an hr | Bi-weekly Job Type: Remote Shift Options: Mon-Fri 8 am - 5 pm Remote HCC Coding Auditor Overview: The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews. The role focuses on ensuring accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS. Candidates must apply clinical documentation standards and industry guidelines to support coding decisions. This role contributes to audit accuracy, process improvements, and helps maintain compliance with state/federal regulations and internal policies.

Position PurposeThe purpose of this position is to apply the appropriate diagnostic and procedure codes to individual patient health information for data retrieval, analysis, and claims processing for the health plan.Nature and ScopeThis position reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters covering a wide variety of clinical cases and services for risk adjustment models. This position is responsible for translating diagnostic phrases utilized by healthcare providers into coded form. The incumbent must have the skill sets to:•Select correct ICD code assignment by proficient analysis and translation of diagnostic statements, physicians' orders, and other pertinent documentation.•Critically evaluate valid encounters, including face-to-face, legibility and valid signature, per Medicare, Commercial and Federal and State requirements•Maintain and grow the current knowledge of the Medicare and Commercial Risk Adjustment...

Job Title: Remote HCC Coding Auditor Pay: $24.65 an hr | Bi-weekly Job Type: Remote Shift Options: Mon-Fri 8 am - 5 pm Remote HCC Coding Auditor Overview: The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews. The role focuses on ensuring accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS. Candidates must apply clinical documentation standards and industry guidelines to support coding decisions. This role contributes to audit accuracy, process improvements, and helps maintain compliance with state/federal regulations and internal policies.

Join to apply for the Lead Risk Adjustment Coder role at Augusta Health 7 months ago Be among the first 25 applicants Join to apply for the Lead Risk Adjustment Coder role at Augusta Health The Lead Risk Adjustment Coder is a system support position who completes coding and abstracting of patient encounters for the purposes of analyzing and improving the accuracy of complexity capture. The specialist works closely with physicians, the Population Health quality and data teams, the coding teams in AMG and the hospital, and the compliance department to identify and deliver high quality and accurate risk adjustment coding. The Lead Risk Adjustment Coder will demonstrate strong understanding of ICD-10-CM, CPT, HCC, and HCPCS coding guidelines and practices for outpatient and inpatient coding. Education High school diploma or equivalent is required 2 years of completed college coursework is preferred Licensure/Certification Certified Professional Coder thru...

Job Description Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses...

Get AI-powered advice on this job and more exclusive features. City/State Virginia Beach, VA Work Shift First (Days) Overview: Sentara Health is seeking to hire a qualified individual to join our team as Risk Adjustment Coder. Position Status : Full-time, Day Shift Position Location: Hybrid work model – 1 day week on-site in Virginia Beach; initial onboarding & training will be in-office Standard Working Hours : 8:00AM to 5:00PM Overview This role consists of educating primary & specialty care providers and staff on appropriate HCC coding & documentation, via virtual sessions and in-person site visits. Duties include retrospective auditing to ensure compliance with appropriate HCC coding & documentation guidelines. Education Associate degree required in healthcare administration, nursing, health information management, accounting, finance, or other related field or Iin lieu of associate’s degree, 4 years of medical coding experience is required...

Job Details Job Location : Miami, FL Salary Range : Undisclosed 1000 NW 57TH CT, Miami, FL 33126 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. This position reports to the...

There's no place likeLiberty Healthcare ManagementCome explore career opportunities with Liberty Healthcare Management, a dynamic leader in the healthcare industry. Join us!We are currently seeking an experienced:RISK ADJUSTMENT CODERJob Summary:Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentationIdentify diagnosis and chart level impairments and documentation improvement opportunities for provider educationDevelop process for chart review Assist coding leadership and clinical team by making recommendations for process improvements to further enhance coding goals and outcomesMaintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulationsConsistently maintain a minimum 95% accuracy on coding quality auditsMeet minimum productivity requirementsAbility to work independently in a remote environmentHandle other related duties as required or assigned Job...

Job Summary: The HCC Coder will serve as a coding resource for internal departments within Medicare Advantage. This resource will be responsible for coding patient charts to capture hierarchical chronic conditions and assigning appropriate diagnosis codes from medical records within guidelines established by CMS. Requirements: Must be able to provide HS Diploma or GED Equivalent upon request Active certified coder certification through AHIMA or AAPC (CRC, CPC, CCS-P), required. Knowledge of medical terminology with an in-depth understanding of ICD-10-CM (knowledge and demonstrated understanding of Risk Adjustment coding and data). Strong clinical knowledge related to chronic illness diagnosis, treatment and management. Minimum 2 years' experience in medical coding preferred

Description Summary: HCC 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, adjustment, or confirmation of diagnoses for risk...

Summary:HCC 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, adjustment, or confirmation of diagnoses for risk adjustment.Perform code...

City/State Virginia Beach, VA Work Shift First (Days) Overview: Sentara Health is seeking to hire a qualified individual to join our team as Risk Adjustment Coder . Position Details Position Status: Full-time, Day Shift Position Location: Hybrid work model - 1 day week on-site in Virginia Beach; initial onboarding & training will be in-office Standard Working Hours: 8:00AM to 5:00PM Role Overview This role involves educating primary & specialty care providers and staff on appropriate HCC coding & documentation through virtual sessions and in-person site visits. Responsibilities include retrospective auditing to ensure compliance with HCC coding & documentation guidelines. Education Requirements Associate degree required in healthcare administration, nursing, health information management, accounting, finance, or related field or 4 years of medical coding experience in lieu of an associate's degree Certification/Licensure Required certifications: CPC, COC, CIC,...

Position Description: Base pay is influenced by several factors including a candidates qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and its why our employees consistently vote us one of the Best Places to Work in PA. The Capital Blue Cross...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:Sentara Health is seeking to hire a qualified individual to join our team as Risk Adjustment Coder.Position Status: Full-time, Day ShiftPosition Location: Hybrid work model - 1 day week on-site in Virginia Beach; initial onboarding & training will be in-officeStandard Working Hours: 8:00AM to 5:00PMOverviewThis role consists of educating primary & specialty care providers and staff on appropriate HCC coding & documentation, via virtual sessions and in-person site visits. Duties include retrospective auditing to ensure compliance with appropriate HCC coding & documentation guidelines.EducationAssociate degree required in healthcare administration, nursing, health information management, accounting, finance, or other related fieldorIin lieu of associate's degree, 4 years of medical coding experience is requiredCertification/LicensureOne of the following certifications are required: Certified Professional Coder...