6 crc certified risk adjustment coder jobs found in Atlanta, GA

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Job Description Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be...

Become a part of our caring community and help us put health first The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. Review and analyze patient medical records to identify accurate ICD-10-CM diagnosis codes, ensuring all relevant conditions affecting patient's care are documented to the highest level of specificity. Validate that documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are regarding the daily...

Job Description Job Description Description: The Certified Professional Coder (CPC) – Primary Care (with Risk Code Review) is responsible for accurate and compliant coding of professional services, verification of demographic and insurance information, and timely resolution of front-end claim edits prior to submission. This role also includes reviewing encounters for accuracy of risk-related diagnosis codes to ensure proper documentation support in compliance with payer and CMS guidelines. The coder supports Southeast Medical Group’s goals for revenue integrity, compliance, and operational efficiency through close collaboration with providers, front-end staff, and billing teams. Requirements: Essential Duties and Responsibilities Coding and Charge Review Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes for all primary care encounters, including preventive, chronic, and acute visits. Ensure all codes are supported by clinical documentation and...

Job Description - Pro Fee Coder - Hospitalist The Pro Fee Coder - Hospitalist will review clinical documentation to assign and sequence diagnostic and procedural codes for hospital-based inpatient and observation encounters to meet the requirements of physician billing and reimbursement. This role focuses on professional fee (pro-fee) coding for hospitalists, ensuring accurate Evaluation & Management (E/M) coding for initial, subsequent, and discharge visits, as well as compliant documentation to support medical necessity and coding integrity. The Coder performs documentation review and assessment for accurate abstracting of clinical data and may interact with providers and clinical staff for clarification and education. DUTIES AND RESPONSIBILITIES: Select and assign ICD-10-CM and CPT/HCPCS codes for hospitalist services, including: Initial hospital care Subsequent daily visits Discharge management Observation and admission-to-discharge same-day...