7 certified risk adjustment coder jobs found

Risk Adjustment Auditor and Physician Educator Health Information Management | Full-Time | Renton, Washington Help Improve Clinical Documentation and Support Better Patient Care Valley Medical Center is seeking an experienced Risk Adjustment Auditor and Physician Educator to join our Health Information Management team. This role combines clinical documentation expertise, risk adjustment auditing, coding knowledge, data analysis, and physician education to help ensure the accurate and complete capture of patient conditions and the clinical complexity of the care we provide. The ideal candidate brings strong experience in Medicare risk adjustment, medical record auditing, ICD-10-CM coding, and physician education , along with the ability to translate complex coding and documentation requirements into practical guidance for providers. This is an opportunity to play a meaningful role in improving documentation quality, supporting value-based care initiatives, and...

Your Role The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. This role involves auditing, monitoring, and evaluating risk adjustment processes, identifying areas of non-compliance, and recommending corrective actions. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs. Responsibilities Your Work In this role, you will:  Conduct regular audits and reviews of risk adjustment data submissions to ensure compliance with regulatory requirements (e.g., CMS, OIG, HHS). Monitor changes in risk adjustment guidelines, policies, and regulations, and communicate updates to relevant stakeholders. Analyze risk adjustment...

Risk Adjustment Coder, Auditor and Educator Location:   West Palm Beach, FL (On-site/Local — Multi-Site Primary Care Medical Group)   Job Type:   Full-Time   Department:   Coding & Risk Adjustment / Clinical Quality About the Role Our multi-site primary care medical group is seeking an experienced   MRA Coder and Educator   to lead risk adjustment coding education and training across our West Palm Beach–area clinics. This role is central to ensuring accurate, complete, and compliant HCC/risk adjustment documentation and coding practices among our primary care providers and clinical staff. The ideal candidate is both a   coding subject matter expert   and a   skilled communicator and presenter   — someone who can translate complex risk adjustment concepts into clear, actionable training that resonates with busy physicians and site-level management, while building strong, trust-based relationships across the organization. Key Responsibilities...

Seeking Certified Medical Coder (CPC or similar) to coordinate our quality programs.  Work with payers to ensure we are identifying and closing care gaps, meeting HEDIS and MIPS measures.  Provide provider and staff education.  Work with our business office to identify and train staff and providers on emerging patterns of denials due to ICD10, CPT and CPT2 coding.  Make sure HCCs and appropriate chronic conditions have been addressed.  Be the liason with our payer population health reps and our ACO.   Excellent benefit package:  We pay 100% of employee Health, Dental, Vision, LTD, $50k Life Ins.policies.  Also STD, Accident, Cancer and Critical Illness policies available.  Bonuses paid in June and December.  Internal Medicine has 2 retirement programs (a profit sharing plan and a 401k) and contributes to both on behalf of the employee.  The employee can also contribute to the 401k on a pre-tax basis.  

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes,  modifiers and audit activities related to health plan operations, risk adjustment, payer audits and  regulatory requirements. This role ensures accurate medical coding, documentation integrity, and  adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess  advanced CPC coding expertise, strong analytical skills, and extensive experience  supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians  and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare,  Medicaid, commercial payer, and applicable federal and state regulatory requirements.  • Conduct coding compliance audits to identify...