46 hcc coder jobs found

Hcc Risk Adjustment Auditor/Coder, Sr. We are looking for experienced HCC Risk Adjustment Auditors/Coders, Sr. to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical...

RadNet, Inc. is seeking a HCC Risk Adjustment/Auditor in Los Angeles, California. This role involves maintaining quality auditing plans for outpatient clinical data and ensuring compliance with coding standards. The ideal candidate should have knowledge in HCC coding, expertise in ICD-9-CM or ICD-10-CM, and excel in medical record audits. This position also offers a competitive pay range of $25 - $27 per hour, along with a comprehensive benefits package including health coverage and flexible spending accounts. #J-18808-Ljbffr

We are looking for experienced HCC Risk Adjustment Auditors/Coders, Sr. to join our team! Position Summary The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and procedure codes. Interface...

Riverside Medical Clinic in Riverside, CA is seeking a coding specialist responsible for auditing and reviewing coding compliance processes related to CPT, HCPCS, and ICD 10. Candidates must possess a current Medical Coding certificate and a minimum of one year experience in HCC coding. This role offers a challenging work environment with growth opportunities within the organization. Riverside Medical Clinic values quality healthcare and aims to transform the delivery of medical services in the community. #J-18808-Ljbffr

RadNet, Inc. is seeking experienced HCC Risk Adjustment Auditors/Coders in Los Angeles. Responsibilities include maintaining and monitoring quality assurance auditing plans and improving coding documentation accuracy. The role requires collaboration with healthcare providers and auditors to ensure compliance with coding classifications, such as ICD-9-CM and ICD-10-CM. Candidates must possess relevant certifications and strong proficiency in Excel and medical record auditing. The position offers a competitive pay range of $33-$36 per hour, along with a comprehensive benefits package. #J-18808-Ljbffr

HCC Medical Coder needed ASAP! Location: Onsite in West Hills, CA Schedule: Monday-Friday, 8:00 AM to 5:00 PM Setting: Established, reputable medical group Team: Supportive finance and coding team WHAT YOU'LL BE DOING (HIGH LEVEL) Review medical records and superbills for accurate HCC and diagnosis coding Audit provider documentation and support accurate risk adjustment Collaborate with providers and internal teams on coding questions Support quality, compliance, and documentation improvement efforts WHAT WE'RE LOOKING FOR Active coding certification (AHIMA or AAPC) Experience with HCC, ICD-10, CPT, and HCPCS Experience in coding, auditing, billing, or claims (1+ year preferred) Knowledge of medical terminology and anatomy Comfortable working in EMRs and Excel Job Type & Location This is a Contract position based out of Calabasas, CA. Pay and Benefits The pay range for this position is $25.00 - $35.00/hr. Eligibility...

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. Essential Job Functions: Hcc Coding and Risk Adjustment (Ra) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines....

Job Details Job Location: Burlingame, CA 94010 Salary Range: $42.79 - $48.75 Hourly ESSENTIAL JOB FUNCTIONS HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy. Provider Training and Clinical Documentation Improvement (CDI) Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding. Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy. Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards. Data Analysis and Reporting Analyze coding data to identify trends, documentation...

6AM City, LLC is offering a fully remote position for a Medical Coder. The role involves coding and auditing services directly to providers, with a flexible schedule to meet daily production goals and maintain high accuracy. Candidates must have a CPC certification, a high school diploma, and three years of coding experience. Benefits include generous paid time off, flexible scheduling, and comprehensive health insurance. #J-18808-Ljbffr

Riverside Medical Clinic in California is seeking a dedicated coder to handle coding and compliance processes related to CPT, HCPCS, and ICD. Candidates should have a minimum of one year experience in medical coding and possess a relevant medical coding certificate. This position offers growth and development opportunities within Universal Health Services (UHS) along with a competitive compensation package, making it a fulfilling environment for those passionate about quality healthcare. #J-18808-Ljbffr

A healthcare organization is seeking a Coder to translate medical records into standardized codes and improve clinical documentation. This remote position requires an Associates degree and coding certifications. Key responsibilities include ensuring compliance with guidelines, educating providers, and safeguarding confidentiality of health information. Candidates should have expertise in CPT and ICD-10 coding and strong communication skills. A competitive pay range is offered alongside comprehensive benefits. #J-18808-Ljbffr

Sr. Associate, Health Care 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....

Job Title Medical Coding Specialist Job Description Job Summary: Provides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties: Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials. Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately. Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff. Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment. Builds positive relationships between providers and the...

Senior Specialty Physician Coder Interventional Our client, a healthcare company, is looking for a Senior Specialty Physician Coder Interventional for their Fountain Valley, CA location. Responsibilities: Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement and ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. In addition, the Senior Specialty Physician Coder will serve as a point of contact for contract coders, maintain the continuity of contract coding operations, and ensure the implementation of client policies and procedures. The Senior Specialty Physician Coder will also work with the Coding Compliance...

Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review network coding opportunities as it pertains to risk adjustment. Ensure that the diagnosis codes for each chronic or...

PACE Medical Coder The PACE Medical Coder will review clinical documentation and diagnostic results as necessary to verify the appropriate assignment of the ICD-10 CM, CPT and HCPCS codes as per Official Guidelines for Coding and Reporting. This position is intended to be a hybrid role, where the incumbent will be expected to primarily work remotely. There is a minimum expectation to attend On-Site Quarterly Meetings; additional on-site presence may be required based on business need. To be considered for this role, candidates must either currently live in California or demonstrate a willingness to relocate prior to employment. Essential Functions of the Job: Review the Chart Progress Notes, patient documentation for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers. Verifies all diagnostic procedural codes from the electronic health record using ICD-10 CPT and HCPCS coding classifications. Communicates effectively with...

Responsibilities Come and join the RMC Family! We have been in the community since 5. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care. SUMMARY Responsible for abstracting, reviewing, auditing and the education of all coding and compliance processes, as they relate to CPT, HCPCS and ICD and/or HCC activity. Qualifications EDUCATION and/or EXPERIENCE : One year minimum experience in the HCC coding field and/or CPT, HCPCS and ICD experience. Proficient in excel and computer friendly. CERTIFICATES, LICENSES, AND...

Responsibilities Come and join the RMC Family! We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care. Summary Responsible for abstracting, reviewing, auditing and the education of all coding and compliance processes, as they relate to CPT, HCPCS and ICD 10 and/or HCC activity. Qualifications To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill,...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

PACE Medical Coder The PACE Medical Coder will review clinical documentation and diagnostic results as necessary to verify the appropriate assignment of the ICD-10 CM, CPT and HCPCS codes as per Official Guidelines for Coding and Reporting. This position is intended to be a hybrid role, where the incumbent will be expected to primarily work remotely. There is a minimum expectation to attend On-Site Quarterly Meetings; additional on-site presence may be required based on business need. To be considered for this role, candidates must either currently live in California or demonstrate a willingness to relocate prior to employment. Essential Functions of the Job: Review the Chart Progress Notes, patient documentation for diagnoses, procedures, and services performed by physicians and other qualified healthcare providers. Verifies all diagnostic procedural codes from the electronic health record using ICD-10 CPT and HCPCS coding classifications. Communicates...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Medical Coder Department: Billing - SoCal Employment Type: Full Time Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801 Compensation: $22.00 - $26.00 / hour Description Astrana Health is currently seeking a highly motivated Medical Coder. This role will report to our Director - Revenue Cycle and enable us to continue to scale in the healthcare industry. Our Values: • Patients First • Empowering the Independent Provider • Be Innovative • Operate with Integrity & Deliver Excellence • Team of One What You'll Do Extract diagnosis codes (specifically HCC codes) and CPT codes from hospital records. Reviews medical records to determine if specific disease conditions were correctly reported based on documentation. Follow the coding guidelines Ensures project activities are in compliance with applicable coding guidelines, government and federal regulations. Regularly and consistently meet quality and productivity standards...

Medical Coder Astrana Health is currently seeking a highly motivated Medical Coder. This role will report to our Director - Revenue Cycle and enable us to continue to scale in the healthcare industry. Our Values: Patients First, Empowering the Independent Provider, Be Innovative, Operate with Integrity & Deliver Excellence, Team of One What You'll Do Extract diagnosis codes (specifically HCC codes) and CPT codes from hospital records. Reviews medical records to determine if specific disease conditions were correctly reported based on documentation. Follow the coding guidelines Ensures project activities are in compliance with applicable coding guidelines, government and federal regulations. Regularly and consistently meet quality and productivity standards established by management Maintain ongoing communication with management regarding coding workload, turnaround time expectations and deliverables. Additional duties as necessary to meet the obligations to...

Job Description Please Note: This is a hybrid position ; however, applicants must reside in California and live within a 2-hour radius of Redlands, CA to be considered. Department: UHC: Managed Care Job Summary: The Coder 1 - Risk Adjustment is responsible for concurrent, prospective, and retrospective clinical documentation review as it pertains to Risk Adjustment Data Validation (RADV) timelines, with an emphasis on completeness and accuracy of provider documentation related to severity of illness and supporting clinical care plan(s) for the validation of Hierarchical Condition Category (HCC) diagnoses. Initiates communication, verbal and written, with providers to facilitate clarification of need for greater specificity, clinical support, and/or completeness of the progress notes. Provides compliant education related to documentation integrity, completeness, and consistency. Keeps providers up to date on CMS, ICD-10-CM, AHA Coding, health plan etc. guidelines as...