27 cms hcc coder jobs found

Prominence Health, a value-based care organization, seeks a Senior Coder to review medical records and ensure accurate coding for diagnosis and service codes across partner practices. The role involves pre, post, and wraparound visit input and may require occasional onsite work and travel for provider education. The ideal candidate has CMS coding knowledge, 2+ years in Risk Adjustment Coding, and CRC/AAPC credentials, with bilingual Spanish preferred and experience navigating EMR systems. #J-18808-Ljbffr

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. Job Overview We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality...

Prominence Health is seeking a Senior Coder to review medical records and ensure accurate reporting of diagnoses and codes across partner practices. This role supports risk adjustment and quality measurement with pre, post, and wraparound input. Occasional onsite work at provider offices is required, with travel to out-of-state trainings. Strong CMS/HCC coding knowledge and bilingual capability (Spanish preferred) enhance success in this role. #J-18808-Ljbffr

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD‑9‑CM/ICD‑10‑CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance efforts....

Job DescriptionJob DescriptionAbout Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.Optima is currently seeking a HCC Risk Coder Specialist to join our team.As the Risk Adjustment Coder you will perform medical record diagnosis code abstraction based upon clinical documentation, ICD-10-CM official...

Join CommunityThe Innovative Healthcare Collaborative of Indiana (IHCI) is a joint venture between Community Health Network and Deaconess Health system.Its goal is to support our sponsors and partners in their strategic evolution to positively impact and improve the healthcare delivery system.Make a DifferenceReporting to the Clinical Documentation Integrity Manager this role performs patient chart reviews to ensure the appropriateness andcompleteness of diagnostic coding with evidence based on CMS HCC standards.The Risk Adjustment Coder is responsible for :Timely accurate and complete review of patient charts following patient encounters utilizing a variety of technical platforms to completeworkflowsValidating diagnosis codes representing patient conditions along with necessary MEAT documentationEnsuring coding is consistent with guidelines from regulatory entitiesConducting audits to meet compliance with ACA standardsCreating post-visit queries with follow upCollaborating with...

Coding SpecialistAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care.An unwavering commitment to our service vision is what makes the difference.It is the foundation of The Memorial Experience.Reviews medical record documentation.May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas / record types to ensure proper billing and compliance.For physician billing, collaborates with billing department to ensure all bills are satisfied.For hospital, routes to billing charge entry errors and / or account edits preventing completion of coding and / or billing.Makes appropriate coding corrections, when advised, and follows procedure to notify billing.Enhances and maintains coding knowledge and skills.Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes.Seeks...

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community.We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area.Position Details:Location:Remote (must reside in the state of Florida, Georgia, North Carolina, South Carolina) Status:Full time (non-exempt) Shift:7:00 AM to 3:30 PM Days:Monday through Friday The Advanced Inpatient Coding Specialist is a full-time remote position.Sign on bonuses available! Responsibilities:The Medical Records Advanced Inpatient Coding Specialist analyzes the multi day, multi-specialty complex documentation for inpatient encounters to assign integrated diagnosis and procedural code using ICD-10-CM and ICD-10-PCS coding systems.Works in conjunction with the medical staff consensus for accurate assignment of intricate diagnoses such as malnutrition and sepsis.Formulates physician queries and monitors bill hold...

Coder 4 Inpatient Coding PositionCoder 4 provides inpatient coding utilizing ICD-10-CM and ICD-10 PCS Coding Classification systems. Utilizes an encoder and computer assisted coding (CAC) software to achieve accuracy and thorough coding. Researches complex coding scenarios and queries physicians on documentation for clarification. This is an inpatient coding position for an experienced, trained inpatient coder. A Coder 4 analyzes clinical documentation; assign appropriate diagnosis, procedure, and abstract the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Assist in the resolution of clinical documentation and provide feedback to providers on the quality of their documentation.ResponsibilitiesCode and abstract clinical and demographic data for...

Medical Coder-Aleca Home HealthAs our company expands, we are actively seeking seasoned Medical Coders. If you're prepared to elevate your career and reap the rewards of an unparalleled compensation package, we extend a warm invitation for you to join us on our journey of growth here at Aleca Home Health!Why Choose Aleca Home Health?Comprehensive Benefits:Access to comprehensive benefit coverage plans to ensure your health and well-being are prioritized.Generous PTO:Enjoy ample paid time off to recharge and pursue personal endeavors, fostering a healthy work-life balance.Tuition Reimbursement:Invest in your professional development with our tuition reimbursement program, empowering you to advance your skills and knowledge.IT Equipment:Equip yourself with the necessary tools for success with state-of-the-art IT equipment provided by Aleca Home Health.Collaborative, Supportive Team:Join a team of passionate professionals dedicated to our core values, including prioritizing people,...

Risk Adjustment CoderPorter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.Position OverviewWe are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health assessments. The ideal candidate will have a strong understanding of CMS risk adjustment and quality initiatives, exceptional attention to...

Department / Unit :Health Information ManagementWork Shift :Day (United States of America)Salary Range :$60,367.47 - $90,551.20This position is Fully RemoteProfessional Coding Auditor will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding / charging / denials follow-up.Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes.Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines.Provide education, instruction and training to providers and coding staff.Act as an expert for the HCC / Risk adjustment coding.This position is remote but does require onsite education to providers as needed.Essential Duties and ResponsibilitiesReview, analyze, and validate CPT and ICD-10 diagnosis codes and...

At Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Code all diagnoses and procedures documented in the medical record for the current encounter.Enter all code information in the HealthQuest system for facility coding in a timely manner.Adhere to compliance regulations set by the government, state, & the Cooper...

About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short Description Code all diagnoses and procedures documented in the medical record for the current encounter.Enter all code information in the HealthQuest system for facility coding in a timely manner.Adhere to compliance regulations set by the...

About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short Description Code all diagnoses and procedures documented in the medical record for the current encounter.Enter all code information in the HealthQuest system for facility coding in a timely manner.Adhere to compliance regulations set by the...

About UsAt Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short DescriptionCode all diagnoses and procedures documented in the medical record for the current encounter.Enter all code information in the HealthQuest system for facility coding in a timely manner.Adhere to compliance regulations set by government,...

CODER II PRN REMOTECamden, NJJob ID 52970 Job Type Per DiemShift DaySpecialty Clerical / AdministrativeApplySaveAbout usAt Cooper University Health Care , our commitment to providing extraordinary health care begins with our team.Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols.We have a commitment to our employees to provide competitive rates and compensation programs.Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement.We also provide attractive working conditions and opportunities for career growth through professional development.Discover why Cooper University Health Care is the employer of choice in South Jersey.Short DescriptionCode all diagnoses and procedures documented in the medical record for the current encounter.Enter all code information in the...

Job DescriptionThe Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR-DRG) or Medical Severity Diagnosis Related Group (MS-DRG) for optimal reimbursement.The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra's coding policies.The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information.ResponsibilitiesAssigns diagnosis and procedure codes.Verifies accuracy of DRGAccurately abstracts required information.Initiates provider coding...

Job Overview Are you an experienced inpatient coder looking to work fully remotely, with a team that values accuracy, continuous learning, and work-life balance? Fairview is hiring-you'll work Monday through Friday, handling 80 hours per pay period.What You'll Do Review and code inpatient clinical records using ICD-10-CM and ICD-10-PCS in alignment with coding guidelines, MS-DRG / APR-DRG reimbursement rules, and Fairview protocols.Validate computer-assisted coding (CAC) output and ensure thorough, accurate coding.Analyze clinical documentation and drill down on severity of illness (SOI), risk of mortality (ROM), HAC, and POA indicators.Collaborate with CDI (Clinical Documentation Integrity) staff to drive provider education and documentation quality.Assist in provider queries to improve documentation specificity.Partner with revenue cycle teams to support prompt claim submissions and optimize financial performance.Required Qualifications (must be met to be considered) :Certificate...

OverviewTalent Sourcing Specialist at Memorial Healthcare SystemSummaryReviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.ResponsibilitiesReviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM)...

Remote Op CoderThe Op Coder works outpatient coding related alerts / edits for Same Day Surgery, Observation, and Wound Care, accounts, predominately post initial / final coding.The CARS-II performs the alert / edit resolution activities in the applicable systems.The alerts / edits shall be worked and corrected according to the established procedures and thresholds, and communicated as appropriate.Position Duties :Compiles daily work list from eRequest, CRT and / or other alert / edit systemsTakes action and resolves alerts / edits for the following patient types following established procedures and thresholds :Same Day Surgery (SDC)Observation (OBV)Wound CareOutpatient Cardiac CathProvides back up / coverage as needed for :Emergency Dept (ED)Recurring (RCR)Clinical (CLI)Provider Office Visit (POV), as applicableEnters detailed notes to update eRequest to provide details if the alert / edit cannot be resolved or must be rerouted to another responsible party for research /...

UCSD Layoff from Career Appointment :Apply by 08 / 12 / 25 for consideration with preference for rehire.All layoff applicants should contact their Employment Advisor.Special Selection Applicants :Apply by 08 / 22 / 25.Eligible Special Selection clients should contact their Disability Counselor for assistance.Candidates hired into this position may have the ability to work remotely.DESCRIPTIONUC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world - one life at a time.We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients.We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.Under general supervision performs in depth...

Summary :Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.Responsibilities :Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures.Conducts, audits and / or...

Job DescriptionJob DescriptionWe are currently seeking a full time Remote Certified Coder-AHIMA / AAPCDuties / Responsibilities include but are not limited to :Uses ICD-10 standards, codes and abstracts medical recordsReviews individual medical records to verify / substantiate diagnosis and proceduresAssigns CPT and ICD-10 codes to all billable encountersQueries physicians to determine the principal diagnosis and appropriate sequencing of other diagnosis and proceduresEnsures that all records are coded in an accurate and timely manner based on customer established timelines.Preferred Experience :Coding Certification required - AHIMA / AAPC (CPC, CPC-H, CCS, CCS-P)AthenaOne, ECW, EPIC, and Intergy experience preferredOB, FQHC, or CHC coding experienceOBGYN experience preferredCoding Evaluation and Management services.Demonstrated understanding of the medical billing and coding lifecycle.Excellent interpersonal, time management, and organizational skills.Proficiency in Microsoft...