12 clinical risk adjustment coder jobs found

Department/Unit:Health Information Management Work Shift: Day (United States of America) Salary Range: $64,972.00 - $97,458.00 The Remote Senior Professional Coder will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding/charging/denials follow-up. Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes. Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines. Provide education, instruction and training to providers and coding staff. Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require onsite education to providers as needed. Essential Duties and Responsibilities Review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by...

Datavant is seeking an experienced HCC Auditor to ensure accurate representation of patient conditions for risk adjustment and reimbursement. You will translate clinical documentation into precise codes and verify the quality of coding work in a remote environment. Requirements include 2 years of HCC coding and auditing, extensive ICD-10 knowledge, and AHIMA or AAPC certifications. The role emphasizes accuracy, speed, and collaboration with a quality team. #J-18808-Ljbffr

Why ThedaCare?Living A Life Inspired!Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world.At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we encourage you...

JOB DESCRIPTION To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

JOB DESCRIPTION To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding directives....

Cano Health is seeking a Risk Adjustment Coder to identify and document CMS HCC related diagnoses from medical records. You will verify code accuracy, ensure complete documentation, and support clinical and billing teams across sites. Responsibilities include coding, chart preparation, on-site reviews, and ongoing support for MRA coding, HEDIS, and STARS initiatives. Requires CPC/CPC-A/CCS-P or CRC credentials and 2 years of coding experience. #J-18808-Ljbffr

It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job SummaryThe Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations. Duties & Responsibilities Review medical record information to identify all appropriate coding based on CMS HCC categories Prepare the medical charts and track patient information via Excel spreadsheets. Complete appropriate paperwork/documentation/system entry regarding...

Who We Are Who We AreCentauri delivers data-driven technology solutions that transform fragmented clinical and member data into actionable intelligence — maximizing accuracy, quality performance, and outcomes for health plans and health systems. Through close collaboration with our customers, Centauri improves patient and member outcomes by providing advocacy, advanced data insights, and intelligent clinical data delivery. The company addresses critical healthcare challenges for complex populations and improves access and quality of care. Headquartered in Tempe, Arizona, Centauri Health Solutions employs 1100 dedicated associates across the country and has been recognized on the Inc. 5000 list , the 2020 Deloitte Technology Fast 500™ , and has been recognized as 2026 Best in KLAS for ADT Notifications. Your Daily Mission The Coding Quality Specialist conducts coding quality reviews on internal and external coders to ensure diagnoses are appropriately and accurately assigned based...

Coding Auditor SeniorCandidates must reside either in Washington or Oregon to be considered for this position.Essential Responsibilities:Proficient in medical record review and translating clinical information into coded data. Identify and assign appropriate codes for diagnoses, procedures and other services rendered, while also validating any Computer Assisted Coded (CAC) assignments for dual coding. Utilizing the Code Base Charge Trigger system (CBCT) and OPTUM 360 EncoderPRO software system for professional surgical services, analyzing and maintaining systems accuracy, validity and meaningfulness for both professional and facility services. Utilizes electronic patient data system and clinical information system (EpicCare) to access patient encounter information. Abstracts and enters clinical data elements as defined by the needs of the organization. Identifies and assigns principal diagnosis and procedure codes, sequencing them as needed for proper Ambulatory Payment...

Title - Inpatient Facility Medical Coder (40h Day) Location - Clackamas, OR, US Job Type - Permanent | Remote Required: Minimum five (5) years experience in coding with four (4) years inpatient facility coding The candidate must have 1 from the following list: Registered Health Information Technician Certificate Certified Coding Specialist Registered Health Information Administrator Certificate Advanced knowledge of medical terminology, pharmacology and medial coding principles for ICD-10-CM, ICD-10-PCS, HCPCS/CPT and coding. Advance knowledge of disease processes, diagnostic and surgical procedures, ICD-10-CM, ICD-10-PCS, HCPCS/CPT classification systems, health information/medical record department responsibilities with knowledge of government regulations and areas of scrutiny for potential fraud and abuse issues. Job description Candidates must reside either in Washintgon or Oregon to be considered for this position. To independently and efficiently...

Job Description Job Description Overview This is a temporary position for approximately 6 months. Responsibilities The Risk Adjustment Coder is responsible for providing support to the Risk Adjustment Department. This position will work closely with the VBC Risk Director, Program Managers, (Nurse Practitoners) NPs and external vendors to assist with managing the Chronic Disease Managed Visit (CDMV) Program through coding charts and queries.     Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.   Collaborate with Lead Coder to review CDMV progress notes and CDMV Summary Continuous streamlined communication with NPs on queries as needed Weekly meeting with Lead coder to discuss any barriers on receiving responses to queries or any questions regarding coding Stay up to dates with CMS Coding Guidelines as identified for Risk Adjustment (CPT and ICD codes) Collaborate with coordinators and specialists for adhoc...

DescriptionAt VMG Health, we're more than just a team of experts; we're trusted partners in the business of healthcare. Backed by a team of over 300 professionals and a history of more than 70,000 engagements since 1995, we bring experience, deep and wide, to every project. Our national client base ranges from large health systems to small practices and everything in between, including investors and private equity firms. Our solutions-oriented approach to client needs is bolstered by our strong market position, extensive contacts, unparalleled tools and solutions, and expert insights. We are proud to serve as the single source for all our clients' valuation, strategic, and compliance needs.? Position Summary VMG Health is seeking an experienced Ophthalmic Compliance Auditor to join its Coding Audit and Compliance (CAC) team. The Ophthalmic Compliance Auditor will provide auditing, compliance, education, and consulting services to a broad range of healthcare clients, including...