32 coder 3 jobs found

Hybrid | Des Moines, IA (Onsite Tues–Thurs, Remote Mon/Fri) $40/hour | 6-Month Contract with Potential for Conversion We are seeking a Certified Risk Adjustment Coder (CRC) to support Medicare Risk Adjustment initiatives through detailed HCC medical record reviews and direct provider engagement. This role is ideal for someone confident, collaborative, and comfortable working onsite with provider teams to drive documentation accuracy and performance improvement. This position requires onsite presence Tuesday–Thursday in Des Moines, IA with 10% local travel , and remote flexibility on Mondays and Fridays. Position Overview This role performs concurrent medical record reviews to ensure accurate capture of HCC conditions and appropriate documentation reflecting patient severity of illness. The coder will collaborate closely with physicians, clinical leadership, and provider engagement teams to improve documentation practices and support compliance with CMS guidelines. Key...

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire. The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms. Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package. #J-18808-Ljbffr

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us. Residency in or relocation to Louisiana is preferred for all positions. POSITION PURPOSE . The Senior Clinical Documentation Integrity Specialist ensures accurate, complete, and compliant clinical documentation that appropriately reflects severity of illness, risk of mortality, and supports correct reimbursement. This role partners closely with providers, coding teams, and practice participants to drive documentation quality, regulatory compliance, and value-based care initiatives. How You Contribute to the Company's Mission In This Role Develops and implements standard processes, job aids, and error prevention tools to strengthen clinical documentation integrity across participating practices. Educates providers and office staff on...

Risk Adjustment Coder IIThe Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization.Job Specifications and Core Competencies:Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions: Hcc Coding and Risk Adjustment (Ra) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines. Ensure all...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Pride Health is seeking a Senior Medical Coder for a remote contract role. The position runs 8am–5pm with a 6-month term and potential extension. Pay ranges from $18 to $20 per hour and compensation is based on experience, credentialing, and education. AAPC or AHIMA certification is required, with at least 3 years of coding experience. Responsibilities include reviewing records, applying ICD-10-CM, CPT, HCPCS, and modifier codes, and performing CMS-HCC/risk adjustment coding as appropriate. #J-18808-Ljbffr

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us. Residency in or relocation to Louisiana is preferred for all positions. POSITION PURPOSE . The Senior Clinical Documentation Integrity Specialist ensures accurate, complete, and compliant clinical documentation that appropriately reflects severity of illness, risk of mortality, and supports correct reimbursement. This role partners closely with providers, coding teams, and practice participants to drive documentation quality, regulatory compliance, and value-based care initiatives. How You Contribute to the Company’s Mission In This Role Develops and implements standard processes, job aids, and error prevention tools to strengthen clinical documentation integrity across participating practices. Educates providers and office staff on...

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...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions: Hcc Coding and Risk Adjustment (Ra) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines....

Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. Candidates should have 3-5 years of risk adjustment coding experience and be able to travel up to 75% for the role. You will review provider documentation, conduct education sessions, and ensure compliance with coding regulations. AAPC or AHIMA certification is required. The role offers a competitive salary range of $70,000 - $85,000 per year. #J-18808-Ljbffr

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

Prominence Health is seeking a Senior Coder responsible for documentation and coding review of medical records at partnered medical practices. This role involves working with provider offices to ensure accurate reporting of diagnoses and service codes. The position may require occasional onsite work and travel for provider education. Qualified candidates should have 3+ years of experience in CMS coding and certification, with the ability to communicate effectively and work independently in a #J-18808-Ljbffr

Universal Health Services is seeking a Senior Coder to handle the documentation and coding review for medical records across partnered practices. Candidates must have a deep understanding of CMS coding and at least 3 years of experience in this field. The role requires both remote work and occasional onsite visits. This position offers a rewarding and challenging work environment along with competitive benefits, including a Loan Forgiveness Program and excellent medical plans. #J-18808-Ljbffr

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to join the Quality - Risk Adjustment team in Orange, CA. The role requires expertise in Medicare Advantage, ACA, and commercial risk adjustment coding, with significant travel to provider sites to support coding education and standards. The ideal candidate will hold CCS/CPC (AAPC/AHIMA) certification, have 3+ years of risk adjustment experience, and be proficient with EHR and coding software. #J-18808-Ljbffr

Senior Clinical Documentation Integrity Specialist We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us. Residency in or relocation to Louisiana is preferred for all positions. Position Purpose The Senior Clinical Documentation Integrity Specialist ensures accurate, complete, and compliant clinical documentation that appropriately reflects severity of illness, risk of mortality, and supports correct reimbursement. This role partners closely with providers, coding teams, and practice participants to drive documentation quality, regulatory compliance, and value-based care initiatives. How You Contribute to the Company's Mission In This Role Develops and implements standard processes, job aids, and error prevention tools to strengthen clinical documentation integrity across participating practices....

Reviewing the accuracy of HCC coded records, the full-time remote Certified HCC Coding Auditor will ensure compliance with Medicare and ICD-10-CM guidelines while supporting coders in identifying errors and maintaining high-quality standards. Key responsibilities Review and audit HCC coded records for accuracy in alignment with guidelines Provide feedback to coders to help them learn from errors and improve coding practices Maintain a quality score of 95% or higher and meet ongoing productivity requirements Required qualifications Certification through AAPC or AHIMA (CPC, CRC, CCS, or CCS-P) is mandatory At least 3 years of HCC coding experience and 2 years of auditing experience Global experience in HCC auditing is preferred Proficient in using EMRs, billing systems, and abstraction platforms Strong understanding of Risk Adjustment Data Abstraction Rules

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...

Job Title: Medical Coder - Virtual Clinic (AWV & HEDIS Gap Closure) - Remote Location: Remote - United States Employment Type: FT W2 **CRC Certified Medical Coder needed to support Medicare Annual Wellness Visits (AWVs), HEDIS gap closure, and virtual care documentation. 100% Remote. CareTalk Health CareTalk Health is a virtual medical practice that specializes in Clinical Process Outsourcing (CPO). We partner with healthcare organizations to build and manage patient and member populations. About the Role The Medical Coder is responsible for accurate and compliant coding of telehealth encounters, with a primary focus on Medicare Annual Wellness Visits (AWVs) and HEDIS gap-closure services. This role ensures proper assignment of ICD-10, CPT, and HCPCS codes, supports quality-measure capture, and maintains compliance with CMS, HEDIS, and payer-specific requirements. Schedule: Monday-Friday 9-5:30pm EST What You'll Do What We're Looking For...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. This is a remote position. The MRA Coding Auditor supports departmental Quality Assessment audits of internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) audits to identify areas of...

Company Overview Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare...

Community Health Choice, Inc. seeks a Risk Adjustment Coder II in Houston, Texas. The role involves advanced medical record reviews and coding of chronic conditions to ensure correct risk scoring, complying with CMS guidelines and internal policies. The ideal candidate has a Bachelor's degree or equivalent experience, and AHIMA/AAPC certification, along with 3-5 years of experience in risk adjustment coding. Join a team dedicated to improving healthcare quality for over 400,000 members. #J-18808-Ljbffr

GeBBS Healthcare Solutions is a leading provider of Revenue Cycle Management (RCM) and Risk Adjustment services, helping healthcare organizations optimize operations, improve financial performance, maintain compliance, and enhance the patient experience. Recognized as a KLAS® Top Performer, GeBBS combines innovative technology, industry expertise, and a commitment to excellence to deliver measurable results for clients across the healthcare industry. We are dedicated to being a trusted healthcare partner by upholding the highest standards of quality, information security, and compliance. At GeBBS, we foster a collaborative and growth-oriented culture where employees are empowered to develop their skills, advance their careers, and make a meaningful impact in transforming healthcare. Flexible work hours - nights and weekends are acceptable. Coders will review member and claim data validation aspects, which include: Member name, Member DOB, Gender, Dates of service, claim type, and...