22 coder i jobs found

Humana Inc. is seeking a Risk Adjustment Coding Professional to perform quality assurance audits of medical records and CMS/ICD-9/10 codes on a remote, nationwide basis. You will ensure coding accuracy is supported by clinical documentation and align with regulations and company guidelines. This role requires CPC/CCS/CCA, 3 years of risk adjustment coding experience, proficiency in MS Office, and strong collaboration skills; overtime and occasional travel to training may apply, with flexible #J-18808-Ljbffr

A healthcare provider in Knoxville is seeking a full-time Certified Medical Coder. The position requires thorough clinical documentation reviews and accurate coding of HCC diagnoses using ICD-10-CM guidelines. Candidates must have current CPC or RHIT certification, be team players with strong communication skills, and maintain HIPAA privacy. This remote role involves occasional onsite meetings, making it crucial for candidates to reside in the Knoxville area. #J-18808-Ljbffr

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...

Senior Risk Adjustment CoderThe 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.What you will do:Risk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing 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 departments to address coding updates and support risk adjustment programs.Compliance...

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...

Millennium Healthcare Management Serv LLC is seeking a Risk Adjustment Coding Specialist to review and validate provider documentation for accurate ICD-10-CM coding reflecting illness severity and care complexity. The role involves prospective, concurrent, and retrospective chart reviews, collaboration with providers, adherence to Medicare guidelines, and participation in coding education to sustain a high accuracy rate and productive coding output. #J-18808-Ljbffr

GeBBS Healthcare Solutions is seeking experienced Risk Adjustment Coders for remote US roles. Review and validate member and claim data, ensure correct ICD-10-CM coding for IP and OP, and identify eligible risk-adjusting diagnoses. Candidates must hold active AAPC or AHIMA certification, have 5+ years verifiable risk adjustment coding experience, and maintain high accuracy (95%) with efficient output. This is a remote US-based opportunity with a pay rate of $27 per hour. #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,...

Galen Medical Group is seeking an EMR Coding Auditor II to improve documentation quality and ensure HCC coding accuracy. You will review charts, validate chronic conditions, and coordinate with physicians to maintain up-to-date problem lists in the EMR. You will train new staff and support the team under the Population Health Manager. The role requires expertise in ICD-10/CPT, strong communication skills, and a commitment to quality and compliance. #J-18808-Ljbffr

Liberty Healthcare Management in Wilmington, NC seeks an experienced Risk Adjustment Coder to abstract medical records for ICD-10-CM coding with high accuracy. Responsibilities include identifying chart level impairments, developing chart review processes, and advising leadership on process improvements. Must stay current with ICD-10-CM codes and CMS requirements; remote work available. #J-18808-Ljbffr

Altegra Health is seeking Remote Certified Coders to perform medical coding duties. You'll abstract information from patient medical records and assign appropriate ICD-9-CM codes, complying with Alta's QA standards. Candidates must possess an active nursing license or coder certification and have at least a year of experience. This remote, temporary role expects reliability and a commitment to tight deadlines. Proficiency in computer applications and knowledge of HIPAA is essential. #J-18808-Ljbffr

Cano Health, LLC is seeking a Risk Adjustment Coder to join our hybrid team in New York. The coder will identify and document coding information crucial for Clinical Condition Categories and ensure diagnosis code accuracy. This role involves regular collaboration with healthcare providers, and candidates must have coding certifications and prior experience. This position emphasizes attention to detail and strong organizational skills, suitable for professionals passionate about healthcare. #J-18808-Ljbffr

A national recruitment agency is looking for experienced HCC Medical Coders for a fully remote position. The role involves reviewing medical charts, assigning ICD-10 codes for risk adjustment, and ensuring compliance with coding standards. Candidates should have at least 2 years of coding experience and be proficient in meeting accuracy and productivity standards. This contract offers a pay rate of $27/hour with specified training and working hours. #J-18808-Ljbffr

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...

St Luke's Health is looking for a Value Based Coder II in Houston, Texas. This role involves reviewing patient medical records to enhance coding opportunities with a strong emphasis on Hierarchical Condition Categories (HCC). The ideal candidate will have 2+ years in outpatient coding and a deep understanding of risk adjustment principles. Responsibilities include providing education to network providers and ensuring compliance with coding guidelines. #J-18808-Ljbffr

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

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...

GeBBS Healthcare Solutions in the United States is seeking an experienced Risk Adjustment Coder to work remotely, reviewing member data and risk-adjusting diagnoses to ensure accurate claims. The role requires active AAPC or AHIMA certification, 5+ years of risk adjustment coding, and maintaining 95% accuracy with at least 3 claims per hour. US-based candidates only. You will handle ICD-10-CM IP and OP coding, validate data fields, and determine if diagnoses should be reported. #J-18808-Ljbffr

About Us Community Health Choice, Inc. (Community) is a non‑profit managed care organization 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 programs including the Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women; the 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 offering individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions; and the Community Health Choice HMO D‑SNP, a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid. Improving members’ experiences is at the heart of every Community...

Astrana Health, Inc. in Monterey Park, CA is seeking a Risk Adjustment Coding Specialist II to verify provider documentation, educate providers, and support CMS risk adjustment initiatives. The role requires travel to provider sites (about 75%) and reports to the Supervisor - Risk Adjustment. Requires CCS/CPC or similar certification and 3+ years of risk adjustment coding, with strong ICD-10-CM/HCC knowledge and EHR proficiency. Competitive salary is $75,000–$85,000 per year. #J-18808-Ljbffr

Astrana Health seeks a Risk Adjustment Coding Specialist II to join our Strategy and Operations team in Monterey Park, CA. The role requires converting provider documentation into compliant HCC coding and educating providers on CMS requirements while traveling to provider sites as needed. Qualified candidates hold CCS/CPC certification with 3+ years of risk adjustment coding experience, strong EHR skills, and the ability to work in a hybrid setting, including on-site visits and remote #J-18808-Ljbffr

Astrana Health is seeking a Risk Adjustment Coding Specialist to support Medicare Advantage, ACA, and Commercial coding initiatives. The role reports to the Sr. Manager - Risk Adjustment and requires frequent travel to provider sites. Strong collaboration with physicians and staff is essential to ensure CMS guidelines are followed. Responsibilities include reviewing records for HCC coding, conducting audits, training staff, and providing process improvements. #J-18808-Ljbffr