27 crc certified risk adjustment coder jobs found

Location: Lee Health - 16281 Bass Rd Suite 300 Fort Myers FL 33908 Department: Lee Pain Service Work Type: Full Time Shift: Shift 1/ to Minimum to Midpoint 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. Facility Specific: Responsible for coding ED, Diagnostic, and Ancillary records. Professional Fee: Responsible for Diagnostic, HCC, Retrospective Coding, Documentation Quality Assurance, and Ancillary Records. Requirements Educational...

Overview Location: Remote - FL Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00 AM to 4:30:00 PM Minimum to Midpoint Pay Rate: $20.50 - $27.85/ hour This is a remote position. Incumbents, who reside in Florida only, may work remotely. There may be occasional situations that require work to be performed on-site at an assigned Lee Health location. 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. Responsibilities Professional Fee Specific: Responsible for coding Surgical Records, Evaluation &...

A healthcare organization in Florida is seeking a Medical Risk Adjustment Coder to support physician practices with coding improvement activities. The ideal candidate will collaborate with healthcare stakeholders, conduct clinical audits, and ensure compliance with coding guidelines. Required qualifications include a High School Diploma and certification as a CPC or CRC, with at least two years of experience in medical coding. This position promises a flexible work environment and competitive benefits. #J-18808-Ljbffr

About Orlando Health At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work”...

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 & Coder, Risk, Specialist, Healthcare, Medical

Coder II - ProFee Trauma Surgery Location: Remote - FL Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00 AM to 4:30:00 PM Minimum to Midpoint Pay Rate: $20.50 - $27.85 / hour This is a remote position. Incumbents, who reside in Florida only, may work remotely. There may be occasional situations that require work to be performed on-site at an assigned Lee Health location. 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. Includes inpatient E/M coding and clinic E/M coding as well as trauma surgery...

Responsible for providing coding quality auditing services and evaluating clinical documentation for all providers within the USFTGP organization. Establishes and provides timely communication of identified quality issues concerning documentation and coding with a target minimum of a 95% accuracy/passing rate. More specifically this team member will: Audit retro and concurrent medical provider clinical documentation while adhering to Medicare guideline • Review documentation to assign/audit correct diagnosis codes Identify areas for documentation improvement and effectively communicates with providers and staff. Perform in a professional manner, exercising good judgment and ethical standards. Interacts effectively and builds respectful working relationships across the organization. • Demonstrate integrity by adhering to high standards of personal and professional conduct. Comply with the Standards of Ethical Coding as set forth by the American Health Information...

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. Sample of Responsibilities: Perform prospective reviews and clinical documentation improvement opportunities Assist healthcare providers in identifying and resolving issues related to incomplete or missing clinical documentation The individual will conduct chart reviews to abstract data not submitted by providers Initiate opportunities to improve documentation Assists other team members as needed to meet the goals of the department. Maintain strictest confidentiality and adhere to all HIPAA guidelines and regulations. Position...

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...

Coder II - Revenue Integrity Lee Health is seeking an experienced Medical Coder II Revenue Integrity to support accurate, compliant outpatient and professional fee coding across our health system. In this role, you will abstract detailed clinical, demographic, and statistical information from medical records and apply correct ICD-10-CM, CPT-4, and APC guidelines. This position plays a key role in our Reconciliation Reduction and Provider Education Project, partnering with Charge Review, reconciliation workflows, and data analysis tools to improve accuracy and financial integrity. The ideal candidate is a self-starter, highly analytical, skilled in communication, and comfortable presenting findings to leaders and providers. This role is primarily remote but requires the candidate to be local to the Fort Myers/Cape Coral area for periodic on-site training or meetings. Core Coding Functions Abstract data from medical records into Epic and Solventum/3M 360 to create accurate...

Location: Remote - FL Department: Coding Work Type: Full Time Shift: 1/8:00:00 AM to 4:30:00 PM Pay Rate: $20.50 - $27.85 / hour Remote position. Incumbents residing in Florida may work remotely. Occasional on-site work at assigned Lee Health location may be required. 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. Includes inpatient E/M coding and clinic E/M coding as well as trauma surgery coding and bedside procedure coding. Experience required in at least E/M coding or trauma surgery coding. Facility...

Memorial Healthcare System Coding Specialist 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. Location: Miramar, Florida 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. For physician billing, collaborates with billing department to ensure all bills are satisfied. For...

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 Summary**The ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review practices for both CMS and Commercial ACOs for quality compliance.**Essential Duties & Responsibilities*** Performs on-site and remote clinical validation audits and interpretation of medical documentation to capture all Medicare Risk codes in coordination with the physician.* Provides guidance and consultation to practice team members to drive improved MRA coding...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

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...

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...

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 Summary**The ACO Coding Auditor is responsible for reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encountering information as it pertains to Medicare Risk Adjustment. You implement ongoing quality improvement activities to assure the Medicare Risk score meets all requirements and act as a consulting MRA advisor to the practices you support. You review practices for both CMS and Commercial ACO’s for quality compliance.**Essential Duties & Responsibilities*** Performs on-site and remote clinical validation audits and interpretation of medical documentation to capture all Medicare Risk codes in coordination with the physician.* Provides guidance and consultation to practice team members to drive improved MRA coding...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Join to apply for the MRA Coder role at Valora Medical Group Altamonte Springs, FL Essential Duties and Responsibilities Review and analyze patient medical records from primary care visits to identify and assign appropriate ICD-10-CM diagnosis codes. Validate documentation supports risk adjustment coding and HCC capture in compliance with CMS guidelines. Collaborate with primary care providers to clarify documentation, improve coding accuracy, and close care gaps. Conduct retrospective and concurrent risk adjustment coding reviews. Educate clinicians on documentation requirements for chronic conditions and HCC accuracy. Maintain up-to-date knowledge of coding guidelines, regulatory requirements, and payer risk adjustment programs. Assist with audits, quality reviews, and compliance monitoring related to risk adjustment coding. Track and report coding trends, errors, and provider documentation opportunities. Ensure compliance with HIPAA regulations and maintain...