5 risk adjustment coder jobs found in Baltimore

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

CareFirst BlueCross BlueShield is looking for a Risk Adjustment Coding Specialist in Baltimore, Maryland. This role involves reviewing and coding medical records, ensuring compliance with federal and state guidelines. You will also develop coding guidelines and provide guidance to junior specialists. The position supports a hybrid working model and offers a salary range between $51,984 and $95,304. The ideal candidate will have an Associate degree in Health Information Technology and at least 3 years of coding experience. Required certifications include CCS or CPC upon hire. #J-18808-Ljbffr

Position Overview The Senior Medical Coding Specialist acts as an internal expert to ensure that value‑based reimbursement and medical policy models are developed and implemented to support Payment Integrity. This role provides expert knowledge to support effective partnership with provider entities, guidance on the appropriate quality‑measure capture and proper use of CPT and ICD‑10 codes in claims submissions. The specialist utilizes coding expertise, combined with medical policy, credentialing and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. This role also provides expertise and mentoring to other team members and will sit within the Payment Integrity team. Essential Functions Consult on proper coding rules in value‑based contracts to ensure appropriate quality‑measure capture and proper use of...

RELI Group, Inc. is seeking an experienced Senior Medical Coder in Baltimore, MD. You will support Medicare Part C Risk Adjustment Data Validation initiatives, performing diagnosis coding across various care settings. The ideal candidate will have a minimum of five years of coding experience and be a certified coder. The role offers an annual salary range of $60,000 to $80,000 based on skills and experience. Join a team that values expertise and impact. #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...