16 outpatient professional coder jobs found

Outpatient Risk Adjustment Coder IHCI Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered and we couldn't do it without you. The Innovative Healthcare Collaborative of Indiana LLC (IHCI) is a company formed through the partnership of Community Health Network (CHNw) and Deaconess Health System (DHS). Both CHNw and DHS place high importance on continuing and advancing population health and value-based care to improve patient health outcomes. Reporting to the Clinical Documentation Integrity...

A leading healthcare provider in Texas is seeking an experienced Value Based Coder II to review medical records for coding opportunities, focusing on Hierarchical Condition Categories (HCC). The role involves developing provider education and ensuring compliance with coding guidelines. Candidates should have a Bachelor's degree in healthcare or equivalent experience, CPC/CCS/CRC certification, and at least 2 years of outpatient coding experience. Competitive hourly pay ranges from $25.30 to $35.74. #J-18808-Ljbffr

A leading healthcare organization in Houston is seeking a Value Based Coder II to independently review patient medical records and identify coding opportunities, particularly focused on Hierarchical Condition Categories (HCC). The ideal candidate will contribute to provider education and process improvement initiatives while ensuring compliance with coding guidelines. This role requires a strong background in outpatient coding and risk adjustment principles, alongside effective communication skills. Competitive pay range available, offering an engaging work environment. #J-18808-Ljbffr

A leading healthcare organization in Houston is seeking an experienced Value Based Coder II focused on reviewing patient medical records and supporting hierarchical condition category (HCC) coding. The role involves developing provider education materials and monitoring compliance with coding guidelines. Candidates should have a bachelor’s degree in healthcare or equivalent, relevant coding certifications, and experience in outpatient and risk adjustment coding. Strong communication and documentation skills are essential. Competitive hourly pay of $25.30 to $35.74 is offered. #J-18808-Ljbffr

Job Overview The HCC Auditor/Coder’s primary objective is to continually improve providers’ reporting and documentation of chronic health care conditions. This is achieved by auditing providers’ patient medical records, reviewing super bills and patient medical records for proper use of diagnosis and procedure codes, and providing education on best coding practices. The role works as an integral member of the Finance Department and interfaces effectively with physicians and office staff on coding issues while researching coding questions as needed. Responsibilities Conduct audits of provider office records and online records by reviewing patient medical records. Review a wide variety of document types, including primary and specialty care records, mental health, substance abuse, inpatient, outpatient, non-submittals (lab), ancillary and pharmaceutical services for HCC values. Provide education to providers and staff on audit findings and communicate best coding practices....

Job Description: Job Description POSITION PURPOSE This position is responsible for ongoing risk adjustment improvement activities Under general supervision this position includes ongoing quality improvement activities to ensure the organization's Risk Adjustment programs are implemented and meet all government requirements. NATURE AND SCOPE This role does not manage people This job reports to: Departmental Leadership Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with: All levels of BCBSLA personnel; physicians and their office personnel; hospitals and allied health provider administration, personnel and third-party medical record vendors; other Blue Plans; Client Association and contracted vendors. QUALIFICATIONS Education High School Diploma or GED required Work Experience 3 years of medical coding experience required with experience in risk adjustment preferred 1 year medical coding audit experience preferred...

Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered - and we couldn't do it without you. Partner with Community Health Network and Deaconess Health System - IHCI The Innovative Healthcare Collaborative of Indiana LLC (IHCI) is a company formed through the partnership of Community Health Network (CHNw) and Deaconess Health System (DHS). Both CHNw and DHS place high importance on continuing and advancing population health and value-based care to improve patient health...

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...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a  Certified Coding Auditor  to work in its New York office or remotely.   Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers....

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 initiate insurance claims and support reimbursement. Maintain and update patient data for long-term...

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...

Are you a certified primary care medical coder who is passionate about improving the accuracy and integrity of patient records? Valleywise Health wants you to join our mission‑driven team focused on providing exceptional patient care through precise and compliant documentation. In this critical role, you will collaborate with providers, coders, and clinical teams to ensure the outpatient medical record tells the full story of the patient’s encounter. You will work under the direction of the Clinical Documentation Improvement Supervisor and utilize a hybrid work environment to improve overall quality and completeness of clinical documentation within the patient electronic medical record using concurrent and/or retrospective review processes. You will work collaboratively with CDI nurses to ensure that the clinical information within the medical record is accurately coded and supported with the provider’s documentation, including accurate documentation to support the capture of...

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 Part D prescription...

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 • 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,...

Summary: The HCC Coding Auditor will perform code audits and abstractions using the Official Coding Guidelines for ICD-10-CM and AHA Coding Clinic Guidance, following all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor will be involved with quality assurance auditing and risk adjustment code abstraction for the following programs: Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is a hybrid role. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk...

Are you a certified primary care medical coder who's passionate about improving the accuracy and integrity of patient records? V alleywise Heal th wants you to join our mission-driven team focused on providing exceptional patient care through precise and compliant documentation! In this critical role, you will collaborate with providers, coders, and clinical teams to ensure the outpatient medical record tells the full story of the patient's encounter. Your work will directly impact quality reporting, revenue cycle performance, and patient outcomes. Under the direction of the Clinical Documentation Improvement (CDI) Supervisor, while utilizing a hybrid work environment, this Outpatient Clinical Documentation Specialist(CDS)-I position uses their coding knowledge and understanding of ICD-10 coding guidelines and standards of compliance to improve overall quality and completeness of clinical documentation within the patient electronic medical record using a concurrent and/or...