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PH
Risk Adjustment Coder Professional Billing II, FT, Days, - Remote
Prisma Health Greenville, SC, USA
Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support...

Feb 09, 2026
Gonzaba Medical Group
Full Time
 
Risk Adjustment Coder
Gonzaba Medical Group San Antonio, TX, USA
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.   1.        Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2.        Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3.        Must...

Jan 09, 2026
VC
HCC Risk Adjustment Coder
Vista Community Clinic Vista, CA, USA
Vista Community Clinic (VCC) At Vista Community Clinic (VCC), we believe healthcare is more than medicine, it's about hope, community, and impact. For over 50 years, we've been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state-of-the-art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient-centered care where it's needed most. As a private, non-profit, multi-specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees. Benefits include: Competitive compensation & benefits Medical, dental, vision Company-paid life insurance...

Feb 17, 2026
UH
Sr Risk Adjustment Coder
University HealthCare Alliance (UHA) Newark, NJ, USA
Senior Risk Adjustment Coder The Senior Risk Adjustment Coder will perform code audits and abstraction 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 Medicare Advantage Risk Adjustment. Locations: Stanford Health Care - University Healthcare Alliance What You Will Do Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with other...

Feb 17, 2026
CH
Risk Adjustment Coder
Carina Health Network Denver, CO, USA
Job Description Job Description 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...

Feb 14, 2026
PM
Risk Adjustment Coder I - Sacramento (Central/South) Hybrid
PriMed Management Consulting Services , Inc. Sacramento, CA, USA
Risk Adjustment Coder I - Sacramento (Central/South) Hybrid 25-234 page is loaded## Risk Adjustment Coder I - Sacramento (Central/South) Hybrid 25-234locations: Sacramento, Californiatime type: Full timeposted on: Posted 4 Days Agojob requisition id: R2344**Were delighted youre considering joining us!**At Hill Physicians Medical Group, were 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. Were regularly recognized as one of the Best Places to Work in the Bay Area and have been recognized as one of the Healthiest Places to Work in the Bay Area. When you join our team, youre making a great choice for your professional career and your personal satisfaction.**DE&I Statement:**At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with...

Feb 11, 2026
AP
Certified Risk Adjustment Coder (Hybrid)
Alpine Physician Partners USA
We're committed to bringing passion and customer focus to the business. Job Description: We are seeking a detail-oriented Certified Risk Adjustment Coder to join our healthcare team. This role involves working directly within a clinical or administrative unit to ensure accurate and compliant coding of medical procedures, diagnoses, and services. The ideal candidate will be embedded in day-to-day operations, collaborating closely with physicians, nurses, and billing staff to support efficient documentation and reimbursement processes. This is a hybrid role, and requires 3 days a week in the office Key Responsibilities: Review and analyze patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes. Ensure coding accuracy and compliance with federal regulations, payer policies, and internal standards. Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies. Submit coded data to billing systems to...

Feb 11, 2026
CC
Risk Adjustment Coder
Colorado Community Managed Care Network Denver, CO, USA
4 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Colorado Community Managed Care Network provided pay range This range is provided by Colorado Community Managed Care Network. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range $53,000.00/yr - $70,000.00/yr Direct message the job poster from Colorado Community Managed Care Network Director of Human Resources and Business Operations Description https://recruiting.paylocity.com/recruiting/jobs/All/3736f22c-4667-493c-828e-5131b681ff09/Colorado-Community-Managed-Care-Network. Applicants will must apply through this link to be considered. Responsibilities: The Value Based Coding Advisor will interact with operational and clinical leadership to assist in the identification of Risk Adjustment/HCC coding opportunities, and will provide targeted education to CHC providers, billers, coders, and...

Feb 06, 2026
VC
HCC Risk Adjustment Coder
Vista Community Clinic Vista, CA, USA
Overview At Vista Community Clinic (VCC) , we believe healthcare is more than medicine, it’s about hope, community, and impact. For over 50 years, we’ve been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state-of-the-art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient-centered care where it’s needed most. As a private, non-profit, multi-specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees. ✨ For eligible employees, benefits include: ✅ Competitive compensation & benefits ✅ Medical, dental, vision✅ Company-paid...

Feb 05, 2026
GM
Risk Adjustment Coder (On-site)
Gonzaba Medical Group San Antonio, TX, USA
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...

Feb 05, 2026
HP
Risk Adjustment Coder I - Sacramento (Central/South) Hybrid
Hill Physicians Medical Group USA
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 Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction. DE&I Statement: At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are. We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and...

Feb 05, 2026
VC
HCC Risk Adjustment Coder
Vista Community Clinic USA
Overview At Vista Community Clinic (VCC) , we believe healthcare is more than medicine, it's about hope, community, and impact. For over 50 years, we've been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state-of-the-art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient-centered care where it's needed most. As a private, non-profit, multi-specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees. For eligible employees, benefits include: • Competitive compensation & benefits • Medical, dental, vision • Company-paid...

Feb 05, 2026
CH
Risk Adjustment Coder
Carina Health Network USA
Job Type Full-time 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...

Feb 05, 2026
UH
Sr Risk Adjustment Coder
University HealthCare Alliance USA
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is a Stanford Health Care - University Healthcare Alliance job. A Brief Overview The Senior Risk Adjustment Coder will perform code audits and abstraction 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 Medicare Advantage Risk Adjustment. Locations Stanford Health Care - University Healthcare Alliance What you will do Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records...

Feb 05, 2026
RM
HCC Risk Adjustment Coder, Sr.
Regal Medical Group Los Angeles, CA, USA
We are looking for experienced HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and...

Feb 17, 2026
AH
Lead Risk Adjustment Coder
Augusta Health Fishersville, VA, USA
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...

Feb 16, 2026
CH
Medicare Risk Adjustment Coder - Provider Educator
Complete Health Manakin, VA, USA
Location: Richmond, VA with travel to corporate office in Jacksonville, FL as necessary Schedule: Monday-Friday Pay Range: $60,000-80,000 per year, dependent on experience Be part of our growing regional company whose main objective is putting our patients first. The provider educator is responsible for identifying opportunities to improve coding, documentation and quality of care. The educator will customize an education plan customized for each provider. Position overview: Plan, conduct and coordinate all aspects of MRA process evaluation and education to internal and external partners, including but not limited to: Communicating a comprehensive understanding of Medicare Risk Adjustment, Documentation & Coding guidelines to both external/internal partners while ensuring compliance with regulatory. Analyze reports to identify and report documentation/coding trends in order to create opportunities for improvement with internal and external partners....

Feb 05, 2026
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