74 certified risk coder jobs found

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding accuracy...

Join UMC Physicians: Where Employee Satisfaction Soars at 96% UMC Physicians is seeking an experienced full-time Family/Internal Medicine Professional Coder to join our team of multi-specialty coders. Under general supervision, the coder reviews and analyzes provider documentation to ensure final diagnoses and procedures are complete, valid, and accurately documented. The Coder assigns ICD-10-CM, CPT, and HCPCS Level II codes for clinic and hospital professional services, ensuring compliance with federal regulations, payer guidelines, and organizational policies. This role is responsible for accurate coding and timely claim submission to support appropriate reimbursement while maintaining the highest standards of coding quality, compliance, and integrity. The coder collaborates with providers, clinic staff, coworkers, and revenue cycle teams to promote complete documentation, resolve coding and billing issues, and support accurate and timely insurance claim processing. The ideal...

Become a part of our caring community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will...

Job Opportunity At Memorial HermannAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.Job DescriptionResponsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses...

Overview Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will perform quarterly chart reviews to...

Datavant is seeking a meticulous HCC Auditor to translate clinical documentation into precise ICD-10 codes for risk adjustment and reimbursement. You will audit charts, adapt to multiple client guidelines, and uphold high quality in a remote, fast-paced environment. Required are 2 years of HCC coding and auditing experience, ICD-10 expertise, and AHIMA/AAPC credentials. Strong communication and organizational skills enable success across projects and teams. #J-18808-Ljbffr

Value Based Coder II Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate...

Certified Medical Coder Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system Selects and accurately records all appropriate records and data on assigned chart abstraction projects Ability to meet productivity and accuracy requirements Performs other duties as assigned Qualifications High School Diploma or GED required A certification in one of the following is required: Certified...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines. The role supports Commercial and Medicare risk adjustment programs and helps ensure accurate documentation and coding. The coder will contribute to trainings, audits, and collaboration across departments to improve documentation quality and compliance. #J-18808-Ljbffr

Job Description Job Description Position Summary The Certified Medical Coder reviews clinical documentation and assigns medical codes in accordance with established guidelines, documentation standards, and organizational procedures. This individual contributor role supports compliant billing, accurate revenue cycle outcomes, and timely resolution of documentation issues through appropriate escalation. Qualifications Required Active professional coding certification (e.g., CPC, CCS, equivalent) Working knowledge of medical coding guidelines and documentation standards Preferred Prior experience in medical coding or revenue cycle operations Familiarity with EHR and coding systems Key Responsibilities and Expected Performance Outcomes Key Responsibilities Review assigned encounters and clinical documentation each day to support complete, accurate coding. Assign medical codes in accordance with current coding guidelines, documentation standards, and...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses and coordinates with physician...

Job Opportunity At Memorial HermannAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.Job DescriptionResponsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses...

Job Opportunity At Memorial Hermann At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Description Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding...

Join Our Caring CommunityHumana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market.ResponsibilitiesDeliver coding and documentation education to providers and clinic staff within IPA clinics.Be a consultative resource and ongoing support for providers in assigned clinics.Conduct documentation audits to identify gaps, trends, and opportunities for improvement.Perform quarterly chart reviews to support coding accuracy and...

Location: Houston, Texas, United StatesCompany: Memorial Healthcare System and Hermann Healthcare SystemPosted: 2026-09-04Location: Houston, Texas, United StatesCompany: Memorial Hermann Health SystemPosted: 2026-09-01At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job SummaryPosition is responsible for leading multiple reviews / audits of healthcare coding, billing, documentation, operations, and related risk areas to support compliance...

A leading healthcare coding company is seeking a professional to handle outpatient coding responsibilities, including assigning ICD-10 and CPT codes in accordance with guidelines. The ideal candidate will have 3-5 years of experience and certification in coding systems. Key duties include maintaining patient privacy, following coding processes, and collaborating with clinical staff. This role emphasizes accuracy and adherence to HIPAA guidelines, requiring a thorough understanding of HCC coding. #J-18808-Ljbffr

Medical Coding Professional 2 Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support...

We've learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®. Join UMC Physicians: Where Employee Satisfaction Soars at 96%! Summary Title: Coder, UMCP Department: UMCP Centralized Billing and Coding Description UMC Physicians is seeking an experienced full-time Family/Internal Medicine Professional Coder to join our team of multi-specialty coders. Under general supervision, the coder reviews and analyzes provider documentation to ensure final diagnoses and procedures are complete, valid, and accurately documented. The Coder assigns ICD-10-CM, CPT, and HCPCS Level II codes for clinic and hospital professional services, ensuring compliance with federal regulations, payer guidelines, and organizational policies. This role is responsible for accurate coding and timely claim submission to support appropriate reimbursement while maintaining the highest standards of coding quality, compliance, and...

HCC Coding Auditor Senior - Health Plan NetworkUS:TX:Irving | Revenue Cycle Audit | Full TimeHCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option.Responsibilities:Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion,...

HCC Coding Auditor - Health Plan NetworkUS:TX:Irving | Medical Coding | Full TimeThe HCC Coding Auditor will perform code audits and abstractions using the Official Coding Guidelines for ICD-10-CM and AHA Coding Clinic Guidance, following all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor will be involved with quality assurance auditing and risk adjustment code abstraction for the following programs: Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is a hybrid role.Responsibilities:Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition,...

Job Title Job Summary Assign ICD-10-CM; PCS; and/or CPT codes to records of discharged patients; depending on the type of visit. Assign appropriate DRG to IP visits. Job Requirements Minimum Education: High school or equivalentMinimum Work Experience: 1 year Required Licenses/Certifications Certified coding specialist must have any of the following certifications: CPCCOCCICCOC-PCPC-ACCS Required Skills; Knowledge; and Abilities Compile and analyze reportsCompile statisticsCompose letters/memorandumsCoordinate meetingsGenerate reportsInput data into computer programsMaintain filing systemsMaintain logsMaintains manualsResearch information Designated Driver: No OSHA Category: 3 - Low Risk #J-18808-Ljbffr

Job TitleJob Summary: Assign ICD-10-CM; PCS; and/or CPT codes to records of discharged patients; depending on the type of visit. Assign appropriate DRG to IP visits.Job RequirementsMinimum Education: High school or equivalentMinimum Work Experience: 1 yearRequired Licenses/Certifications: Certified coding specialist must have any of the following certifications:CPCCOCCICCOC-PCPC-ACCSRequired Skills; Knowledge; and Abilities:Compile and analyze reportsCompile statisticsCompose letters/memorandumsCoordinate meetingsGenerate reportsInput data into computer programsMaintain filing systemsMaintain logsMaintains manualsResearch informationDesignated Driver: NoOSHA Category: 3 - Low Risk

Medical Coding Professional 2Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands.As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices.This is a hybrid position that requires occasional travel within the assigned market.Responsibilities:Deliver coding and documentation education to providers and clinic staff within IPA clinics.Be a consultative resource and ongoing support for providers in assigned clinics.Conduct documentation audits to identify gaps, trends, and opportunities for improvement.Perform quarterly chart reviews to support coding accuracy and...