15 coder 1 risk adjustment jobs found

Job Description Job Description Remote Medical Coder Location: remote, Florida Compensation: $21-26/hr., commensurate with experience and qualifications Our Story : Physician Care Centers (PCC) is a growing healthcare MSO with 70+ value-based primary care clinics serving patients across Florida, Texas, Georgia, South Carolina, and Nevada. With a team of 500+ professionals, we’re committed to delivering exceptional care and improving patient outcomes. The Role: We’re seeking a Medical Coder to ensure accurate, compliant coding that supports revenue integrity and risk adjustment performance. Under the supervision of the Revenue Cycle Manager, you’ll review provider encounters, ensure accurate HCC capture, collaborate with clinical teams, and support documentation improvement. What You’ll Do: Review and accurately code all provider encounters (office visits, procedures, preventive care, chronic condition management). Ensure complete and compliant...

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment coding and...

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Responsible for auditing physician evaluation and management and procedures coding and billing to ensure they meet the official coding guidelines, medical necessity and compliance with regulatory requirements. Responsibilities: Prepare formal audit report of audit background, steps and findings to presentation to executive leadership and the Board of Commissioners.Participates in investigations and responds to questions, issues, reports and formal inquiries by federal and state agencies of possible violations or non- compliance matters raised by employees, patients, physicians and the public.Monitor and assess compliance with state and federal laws and the System's policies and procedures to identify...

Coder I - ProFee Abstracts data from medical records into Epic and 3M 360 to provide a detailed case summary of medical, demographic, and statistical information. Identifies and codes diagnoses and procedures for medical records according to ICD-10-CM and CPT-4 guidelines, including department modifications. Identifies primary diagnosis and procedure as well as pertinent secondary diagnoses and procedures. Follows procedures mandated by government and other payers for completion of coded data including APC assignments and HCC codes. Professional Fee: Responsible for Diagnostic, HCC, Retrospective Coding, Documentation Quality Assurance, and Ancillary Records. Educational Requirements High School Diploma or Equivalent Required Experience Requirements 1 Year Outpatient Coding Preferred Additional Requirements 1 Year of Outpatient (Acute Care Hospital or Physician) Coding or completion of coding course Certifications/Registration Requirements CPC (Certified Professional...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in...

Risk Adjustment Nurse/Coder AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA) in Doral, FL! Full-time permanent position (40 hours) Standard working hours: 8am to 4:30pm EST, M-F This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary The Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories...

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

Physicians' Primary Care of Southwest Florida is a premier physician-owned and managed multi-specialty practice with locations in Cape Coral, Estero, Fort Myers, and Lehigh Acres. We are currently seeking an in-house HCC Risk Adjustment Coder for our Compliance and Coding department located in Fort Myers. This is not a remote coding position, must reside in Lee County Florida . Schedule is Monday through Friday, Day Shift. Are you a coding enthusiast who enjoys solving documentation puzzles and ensuring medical services are accurately translated into codes? Our medical practice is looking for a Certified Medical Coder whom is detailed- oriented , organized and passionate about compliance and accuracy. In this role, you will help bridge the gap between clinical care and reimbursement by ensuring medical records are coded correctly and claims are submitted cleanly. Sample of Responsibilities: Review provider documentation and assign accurate ICD-10 CM , CPT and HCPCS...

Company Overview: Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person. It's no wonder 98% of patients report being fully satisfied with Upward Health! Job Title & Role Description: The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT/HCPCS codes, ensuring compliance with coding guidelines, third-party reimbursement policies, and accreditation standards. This...

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...

Health Information Management (HIM) Coder Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities For hospital encounters, routes to billing charge entry errors and/ or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections when advised and follows procedure to notify billing. Reviews chargemaster generated CPT/HCPCS codes, when errors are found Coding Management is notified to alert Charge Management to educate department making errors. Makes appropriate coding corrections when...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and...

Location: Remote - FL Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00 AM to 4:30:00 PM Pay Rate: $20.00 - $25.45 / hour Summary Abstracts data from medical records into Epic and 3M 360 to provide a detailed case summary of medical, demographic, and statistical information. Identifies and codes diagnoses and procedures for medical records according to ICD-10-CM and CPT-4 guidelines, including department modifications. Identifies primary diagnosis and procedure as well as pertinent secondary diagnoses and procedures. Follows procedures mandated by government and other payers for completion of coded data including APC assignments and HCC codes. Professional fee: Responsible for Diagnostic, HCC, Retrospective Coding, Documentation Quality Assurance, and Ancillary Records. Requirements Education: High School Diploma or Equivalent Experience: 1 year outpatient coding (preferred). Completion of coding course considered. Licensing: State of Florida licensure...

Company Overview :Upward Health is an in-home, multidisciplinary medical group providing 24 / 7 whole-person care.Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help.Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person.It's no wonder 98% of patients report being fully satisfied with Upward Health!Job Title & Role Description :The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT / HCPCS codes, ensuring compliance with coding guidelines, third-party reimbursement policies, and accreditation standards.This role...

A leading medical center in Florida seeks a Risk Adjustment Coder to perform coding audits and ensure accuracy in health records. Candidates should have 10+ years in coding, strong knowledge in coding guidelines, and relevant certifications. This position emphasizes teamwork to improve patient care and data quality through education and compliance initiatives. Competitive pay starting at $25.23 per hour with benefits included. #J-18808-Ljbffr