11 cms hcc coder jobs found

Job Duties At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment Coding Auditor Location: Remote Career Area: Customer Service/Operations About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding...

Blue Cross and Blue Shield of Minnesota is looking for a Risk Adjustment Coding Auditor. The role ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices. Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements. Performs retrospective and prospective chart reviews to ensure accurate risk adjustment reporting. Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider‑reported diagnosis codes based on medical record documentation. Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories. Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with...

Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program. Medical Coder - Risk Adjustment Specialist- Remote Schedule: M-F 8:00 AM-5:00 PM Salary: $58,000-$66,000 (Based on Experience) Essentials: Collaboration for Risk Adjustment Integrity: Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process. Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity. Medication Documentation Review and Diagnostic Coding: Reviews and interprets provider documentation to extract critical information. Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical record. Assures the final...

Join our team at Regions Hospital as a Health Information Coding Analyst II., Outpatient Same Day Surgery Coder. As a coding analyst, you will support multiple sites and actively participate within a team who performs a wide variety of complex coding scenarios to ensure accurate assignment of ICD-10 and CPT Codes. This position: Completes coding analysis of each individual patient stay. Provides accurate diagnoses, procedures and other relevant database information for optimal financial reimbursement, collection of unique and pertinent information and accumulation of statistical data. Perform related duties as assigned. Work schedule: FTE: 1.0 (40 hrs. weekly) Remote, Monday-Friday Flexible. Candidates must live in MN, WI, IA, ND, or SD. Required Qualifications: Education: Graduate from an associate or bachelor's degree program in health information, completion of a coding specialist program or successful completion of AHIMA or AAPC coding credential exam....

Adecco Healthcare is working with our client to hire REMOTE Medical Coders for a 6-month contract position. Pay Range: $16.50-$17.89/hour DOE Location: Remote Shift: 40-hours/week - normal business hours - OT may be required Responsibilities Accurate coding of professional services from medical records in multiple settings (clinic, outpatient, inpatient facilities) Apply understanding of relevant medical coding subject areas Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes Identify areas in clinical documentation that are unclear/incomplete and generate queries to obtain additional information Follow up with providers as needed Utilize medical coding software programs or reference materials to identify appropriate codes Provide information or respond to questions from medical coding quality audits Educate and mentor others to improve medical coding quality Demonstrate basic knowledge of the...

Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. Benefits Highlights Medical: Multiple plan options. Dental: Delta Dental or reimbursement account for flexible coverage. Vision: Affordable plan with national network. Pre-Tax Savings: HSA and FSAs for eligible expenses. Retirement: Competitive retirement package to secure your future. Responsibilities This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs. The HB IP Coder reviews, interprets, and...

Health Information Coding Analyst II, Outpatient Same Day Surgery Coder Join our team at Regions Hospital as a Health Information Coding Analyst II. As a coding analyst, you will support multiple sites and actively participate within a team who performs a wide variety of complex coding scenarios to ensure accurate assignment of ICD-10 and CPT Codes. This position: Completes coding analysis of each individual patient stay. Provides accurate diagnoses, procedures and other relevant database information for optimal financial reimbursement, collection of unique and pertinent information and accumulation of statistical data. Perform related duties as assigned. Work schedule: FTE: 1.0 (40 hrs. weekly) Remote, Monday-Friday Flexible. Candidates must live in MN, WI, IA, ND, or SD. Required Qualifications: Education: Graduate from an associate or bachelor's degree program in health information, completion of a coding specialist program or successful completion of AHIMA or...

Coder 4 Inpatient Coding PositionCoder 4 provides inpatient coding utilizing ICD-10-CM and ICD-10 PCS Coding Classification systems. Utilizes an encoder and computer assisted coding (CAC) software to achieve accuracy and thorough coding. Researches complex coding scenarios and queries physicians on documentation for clarification. This is an inpatient coding position for an experienced, trained inpatient coder. A Coder 4 analyzes clinical documentation; assign appropriate diagnosis, procedure, and abstract the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Assist in the resolution of clinical documentation and provide feedback to providers on the quality of their documentation.ResponsibilitiesCode and abstract clinical and demographic data for...

Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans (https://jobs.mayoclinic.org/benefits/) – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. Benefits Highlights Medical: Multiple plan options. Dental: Delta Dental or reimbursement account for flexible coverage. Vision: Affordable plan with national network. Pre-Tax Savings: HSA and FSAs for eligible expenses. Retirement: Competitive retirement package to secure your future. Responsibilities This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for...

Job Overview Are you an experienced inpatient coder looking to work fully remotely, with a team that values accuracy, continuous learning, and work-life balance? Fairview is hiring-you'll work Monday through Friday, handling 80 hours per pay period.What You'll Do Review and code inpatient clinical records using ICD-10-CM and ICD-10-PCS in alignment with coding guidelines, MS-DRG / APR-DRG reimbursement rules, and Fairview protocols.Validate computer-assisted coding (CAC) output and ensure thorough, accurate coding.Analyze clinical documentation and drill down on severity of illness (SOI), risk of mortality (ROM), HAC, and POA indicators.Collaborate with CDI (Clinical Documentation Integrity) staff to drive provider education and documentation quality.Assist in provider queries to improve documentation specificity.Partner with revenue cycle teams to support prompt claim submissions and optimize financial performance.Required Qualifications (must be met to be considered) :Certificate...

Requisition number: 2366533 Job category: Medical & Clinical Operations Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Assigns accurate diagnostic and procedure codes according to clinical documentation and official coding guidelines for outpatient hospital professional accounts...