6 certified risk adjustment coder jobs found

Job Summary: The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic data base and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record Our Investment in You: Full-time remote work Competitive salaries Excellent benefits Responsibilities Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. Ability to code government and state models. This includes code everything projects. Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. Ability to maintain a 95% accuracy rate on all coding projects. Coders assist...

WellSense Health Plan is seeking a Coder to manage chart abstraction, vendor auditing and reporting in line with state and federal regulations. You will abstract from in-patient and out-patient records and document findings in electronic databases or spreadsheets. The role requires up-to-date ICD-10-CM knowledge, CMS guidelines, and independence in a remote environment. Minimum 5 years in coding, with at least 3 in Risk Adjustment; CPC certification is required. #J-18808-Ljbffr

Position Title: Professional Coder - Radiology Department: Revenue Integrity Job Description: New to OU Health? Ask your recruiter about our competitive wages and total rewards package. Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. SPECIALTY AREA: Neuro Interventional Radiology Looking for a coding team to love at OU Health? This is it! While this role is specifically searching for an experienced Neuro Interventional Radiology coder, we also cover multiple specialties so there's opportunities to learn and grow . 100% remote. Flexible shifts once training is complete. Opportunity to work four 9 hour days, and one 4 hour day. So if you're work-from-home ready, work well independently, and have strong coding skills we just may be the right fit for you! ***The ideal candidate would have teaching hospital or trauma center coding experience and familiarity with CT, MRI...

Professional Coder - RadiologyIndependently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic and research enterprise.Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position.Code complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment. Advanced expertise in ICD?10?CM, CPT®, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.Resolve coding-related edits and denials by identifying root cause, coordinating documentation...

JOB SUMMARY: The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. KEY RESPONSIBILITIES: • Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements. • Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines. • Identify unsupported diagnoses, over coding, under-coding, and documentation gaps. • Provide detailed audit findings and recommendations to coding teams, providers, and leadership. • Monitor compliance with CMS Risk Adjustment Data Validation (RADV)...

Professional Coder - RadiologyIndependently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic and research enterprise.Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position.Code complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment. Advanced expertise in ICD?10?CM, CPT®, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.Resolve coding-related edits and denials by identifying root cause, coordinating documentation...