400 crc certified risk adjustment coder jobs found

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Omega Healthcare Management Services seeks a Coder HCC to review medical records, assign accurate diagnoses and procedures, and support DRG/APC reimbursement across inpatient, outpatient and professional services. The role emphasizes risk adjustment, coding accuracy, HIPAA compliance, and collaboration with care teams. Requires CPC/CCS/RHIT/RHIA or equivalent credentials and at least two years of risk adjustment and 3M/Epic experience. #J-18808-Ljbffr

A healthcare organization in California is seeking a Medical Coder to perform chart reviews, coding audits, and provide training on ICD-10 codes. The ideal candidate will have an AA or AS degree, relevant coding credentials, and two years of healthcare experience. Responsibilities include coding audits, maintaining knowledge of coding guidelines, and assisting with billing inquiries. This role offers competitive benefits including free medical, dental, and vision insurance. #J-18808-Ljbffr

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Remote Contract Position Job Duties: Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment Meet department production and quality standards Research regulatory guidelines for supporting documentation Prepare coding reports using excel Prepare oral and/or written reports of work activity to Supervisor Be responsible and accountable for maintaining the confidentiality, integrity, and availability of protected health information. Follow HIPAA security policies and procedures affecting your job, and report any suspected or actual violation or breach Other duties as assigned Minimum Requirements: Minimum 3 years of PACE risk adjustment coding experience Extensive ICD-10-CM coding experience, with Risk Adjustment models for PACE Excellent written and verbal communication skills Ability to "own" project and complete charts assigned in work queue daily Detail oriented and deadline driven attitude Ability to think critically and determine the best...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Details Compliance Auditor Job Description JOB SUMMARY Under general supervision, performs risk-based audits of clinical documentation, coding, and billing records to ensure that documentation supports services billed and complies with applicable regulatory and organizational requirements. This position independently validates documentation and coding compliance, identifies areas of compliance risk, and supports internal audit activities and external audit readiness across hospital-and provider-based settings. This role is outcome-driven and requires the ability to independently manage audit workload, documentation, and deadlines. ESSENTIAL FUNCTIONS • Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records by analyzing medical records, coding records, and health system bills to validate that documentation supports services billed and complies with applicable regulations and guidelines. • Evaluates...

This is a remote contract position.   Job Duties: Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment Meet department production and quality standards Research regulatory guidelines for supporting documentation Prepare coding reports using excel Prepare oral and/or written reports of work activity to Supervisor Be responsible and accountable for maintaining the confidentiality, integrity, and availability of protected health information. Follow HIPAA security policies and procedures affecting your job, and report any suspected or actual violation or breach Other duties as assigned Minimum Requirements: Minimum 3 years of PACE risk adjustment coding experience Extensive ICD-10-CM coding experience, with Risk Adjustment models for PACE Excellent written and verbal communication skills Ability to “own” project and complete charts assigned in work queue daily Detail oriented and deadline driven attitude Ability to think...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Specialty Coder At St. Luke's, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke's is truly a great place to work. What You Can Expect: Under limited supervision, Specialty Coder is responsible for reviewing applicable documentation and assigning or validating appropriate procedure and diagnosis codes. Reviews notations, diagnosis, or procedure information in medical record to assign or validate appropriate diagnosis and procedure codes, ensuring accuracy and appropriateness of codes. Applies basic knowledge of coding to solve unique or new cases resulting in the assignment and sequencing of diagnosis and procedure codes. Ensures documentation...

Medical Risk Adjustment Coder The Medical Risk Adjustment Coder supports the physician practices and the Care Coordination Department with Coding Improvement activities using various clinical data systems. Responsibilities include collaborating with internal and external clients to streamline and optimize accurate diagnosis code capture, conducting clinical chart and patient billing audits, adhering to coding rules and CMS guidelines, assisting with HEDIS chart reviews, performing analysis and focused chart reviews, facilitating coding and documentation improvement educational materials, and providing support in the Care Coordination Department. The role also involves performing data validation and integrity functions, monitoring quality, cost, and efficiency, and maintaining compliance with Orlando Health policies. Qualifications include a high school diploma or equivalent, one of the following certifications: Certified Professional Coder (CPC) or Certified Risk Adjustment...

Job Summary: We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must be CPC and CRC certified with strong risk adjustment coding expertise and proficiency in Microsoft Office Suite. Required Skills: 8+ years of Risk Adjustment coding and auditing experience Experience supporting CMS RADV first- and second-pass audits Active CPC (Certified Professional Coder) certification Active CRC (Certified Risk Adjustment Coder) certification Proficiency in Microsoft Office Suite (Excel, Word, Outlook) This is a remote position.

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary (List Format) - Outpatient E/M Coder - Assign accurate CPT®, ICD-10-CM, and HCPCS Level II codes for outpatient E/M services based on Medical Decision Making (MDM) and current guidelines. - Apply HCC (Hierarchical Condition Category) coding principles to support risk adjustment and complete clinical documentation. - Review provider documentation for completeness, specificity, and medical necessity; query providers when needed. - Ensure compliance with CMS, AMA, ICD-10-CM guidelines, payer requirements, and internal coding policies. - Meet established coding productivity and quality benchmarks. - Assist with coding audits, provide education feedback, review denials, and support other coding projects as assigned. - Participate in team meetings, training sessions, and after-hours meetings scheduled in Pacific Time. - Maintain patient privacy and confidentiality in accordance with HIPAA and organizational standards. - Stay updated on coding guideline changes,...

GBMC Health Partners is seeking a Clinical Documentation Improvement Nurse/Nurse Coder to join our Primary Care team. The ideal candidate is a clinically experienced nurse coder who is EMR savvy, knowledgeable in HCC and ICD-10 coding, with exposure to ambulatory medicine. Responsibilities include chart review, identifying documentation improvement opportunities, and educating practice physicians on documentation and coding changes. EPIC experience preferred. #J-18808-Ljbffr

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...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...