40 hcc coder jobs found

Job Title: HCC | Risk Adjustment Coder Location: Newark, NJ (100% Remote) Duration: 6 months (possible extension) Pay Rate: $30 - $35/hr. on W2 Schedule: Regular Business Hours. Important Details: Candidates can be located in any one of the five states: NJ, NY, PA, CT, and DE You will be required to travel for the pickup and return of equipment, and/or laptops that need servicing. Job Summary: Responsible for reviewing, auditing, coding, and analyzing medical records to ensure accurate diagnosis documentation and HCC abstraction. Supports Medicare, Medicaid, Commercial Risk Adjustment programs, and RADV audits while ensuring compliance with ICD-10 coding guidelines and risk adjustment regulations. Key Responsibilities Review medical records for coding accuracy, completeness, and compliance Abstract and validate HCC diagnoses using ICD-10, CPT, and HCPCS coding systems Support Medicare Advantage, Medicaid, Commercial, and ACA risk...

Ampcus Inc is looking for a Medical Coder to review, audit, and analyze medical record documentation for accuracy. This position requires proficiency in CPT and ICD coding to support audits under ACA and Medicare Advantage guidelines. Qualifications include a current RHIT or similar certification and 2-5 years of coding experience. Applicants should possess strong communication skills, demonstrate ethical practices, and work well in a team environment. #J-18808-Ljbffr

Creative Solutions Services, LLC in Newark, NJ is looking for a Medical Coder responsible for auditing and coding medical record documentation. The ideal candidate will have a Registered Health Information Technician certification, with at least 2 years of medical coding experience. The role supports various audits for Medicare and commercial lines, requiring strong proficiency in coding guidelines, effective communication, and teamwork. #J-18808-Ljbffr

Axelon Services Corporation is seeking a skilled medical coder in Newark, NJ. This role involves reviewing and analyzing medical record documentation for accuracy and compliance with ICD-9/ICD-10 guidelines. Applicants should possess RHIT certification or similar credentials along with at least two years of experience in medical coding. Strong knowledge of coding systems and excellent communication skills are essential. Join a team focused on continuous improvement and quality assurance in healthcare documentation. #J-18808-Ljbffr

Summary: This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data using ICD-9/ICD 10-CM and other standard classification coding systems. Support the...

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Day - 08 Hour (United States of America)This is a Stanford Health Care - University Healthcare Alliance job.A Brief OverviewThe Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment.LocationsStanford Health Care - University Healthcare AllianceWhat you will doRisk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing medical records to ensure accurate HCC coding and...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more These are remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical records....

Medical Coding & Risk Adjustment Auditor (Remote Contract) Location: Remote Duration: 6+ Month Contract Client: New Jersey-Based Healthcare Organization Position Summary We are seeking an experienced Medical Coding & Risk Adjustment Auditor to support a healthcare client's Risk Adjustment and Data Validation initiatives. This role is responsible for reviewing, interpreting, auditing, coding, and analyzing medical record documentation to ensure diagnosis accuracy, proper documentation, and Hierarchical Condition Category (HCC) abstraction. The position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation (RADV) audits, as well as ongoing Risk Adjustment activities across Medicare, Medicaid, and Commercial lines of business. Key Responsibilities Review, interpret, and translate CPT, HCPCS, ICD-9, and ICD-10 codes for HCC abstraction. Audit medical records for completeness, accuracy, and compliance with applicable...

Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS) A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description One of our direct client is looking for potential candidate with the below mentioned skills Direct Client: Immediate Interview Contract to Hire Position: Provider Liaison MUST HAVE: 5 years of experience into Project Management At least 2 years of experience after CPC or CCS certification Bachelor's degree is a must Certifications AAPC Certified Professional Coder (CPC) or...

Professional Coder I Our client, a Health Insurance company, is looking for a Professional Coder I for their Newark, NJ location. Responsibilities: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations....

Certified Professional Coder (CPC) Lead/Provider Liaison A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. This is Contract position with my direct client Job Description Direct Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJ Duration: Contract to Hire Job Summary: The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational...

Position Certified Professional Coder / Bill Review Expert Location Remote Employment Details FMLA: Non-Exempt, Full-Time Schedule: M-F 8:00 AM - 4:30 PM Must Have PIP experience with a high level understanding of fee schedule guidelines in NY, NJ, FL, or MI required. CPC in good standing with AAPC required (may consider candidate with strong PIP experience, e.g., NJ/NY PIP adjuster). Responsibilities Use various resources to support reviews, such as CPT guidelines, CPT Assistant, Encoder Pro, and 3M Software. Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and/or NY-covered insureds. Interpret medical documentation to ensure accuracy of billed services (e.g., CPT, HCPC codes). Assign proper CPT and HCPC codes based on the review outcome. Review CPT codes for unbundled services. Review billed modifiers for accuracy of use. Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement. Interpret fee schedule...

Associate Director / Director, Medical Science Liaison Womens Health US-- Job ID: 2026-1902 # of Openings: 1 Category: Medical Science Liaison BESTMSLs Overview This field-based Medical Science Liaison role supports the Womens Health therapeutic area across the United States (exact territory to be determined), with a focus on engaging key opinion leaders (KOLs) and healthcare providers in high-quality scientific exchange. The Associate Director/Director will serve as a critical link between external stakeholders and the Medical Affairs organization, driving insight generation and contributing to the development and execution of medical strategy. This role requires deep expertise in Women's Health, including exposure to contraception, and a strong ability to translate complex clinical data into meaningful, actionable discussions. The individual will proactively identify unmet educational needs, deliver non-promotional scientific support, and play a key role...

Associate Director, Global Medical Oncology, Medical Communications, Hematology Working with Us Challenging. Meaningful. Life-changing. Those aren't words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You'll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible. Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Position Summary Position reports to...

CODER III - REMOTE Camden, NJ Job ID 69736 Job Type Full Time Shift Day Specialty HIM/Coding Apply About us At Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description Coder III demonstrates proficiency in coding high acuity inpatient accounts and/or coding of...

Urgent Requirement - Certified Professional Coder Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right...

Associate Director / Director, Medical Science Liaison Womens Health US-- Job ID: 2026-1902 # of Openings: 1 Category: Medical Science Liaison BESTMSLs Overview This field-based Medical Science Liaison role supports the Womens Health therapeutic area across the United States (exact territory to be determined), with a focus on engaging key opinion leaders (KOLs) and healthcare providers in high-quality scientific exchange. The Associate Director/Director will serve as a critical link between external stakeholders and the Medical Affairs organization, driving insight generation and contributing to the development and execution of medical strategy. This role requires deep expertise in Women's Health, including exposure to contraception, and a strong ability to translate complex clinical data into meaningful, actionable discussions. The individual will proactively identify unmet educational needs, deliver non-promotional scientific support, and play a key role...

Job Description Job Description Job Title: Medical Biller Location: Pennsauken, NJ Industry: Healthcare Pay: $20 - $25 / Hour (based on experience) Benefits : The position is eligible for medical, dental, vision, and 401(k) About Our Client: Our client is a well-established RCM company working with local health systems to handle billing, collections, eligibility services, and financial counseling, often on-site at hospitals. They have been recognized for providing reliable and efficient service with a strong management team in place. Job Description: The Medical Biller will support a growing team handling billing for hospitals, including UB-04 claims and CMS 1500 forms. This is an excellent opportunity for someone looking to grow a long-term career in medical billing with extensive training and career advancement potential. Key Responsibilities: Follow up on UB-04 claims for hospital billing and CMS 1500 claims for professional...

Associate Director / Director, Medical Science Liaison Womens Health US-- Job ID: 2026-1902 # of Openings: 1 Category: Medical Science Liaison BESTMSLs Overview This field-based Medical Science Liaison role supports the Womens Health therapeutic area across the United States (exact territory to be determined), with a focus on engaging key opinion leaders (KOLs) and healthcare providers in high-quality scientific exchange. The Associate Director/Director will serve as a critical link between external stakeholders and the Medical Affairs organization, driving insight generation and contributing to the development and execution of medical strategy. This role requires deep expertise in Women's Health, including exposure to contraception, and a strong ability to translate complex clinical data into meaningful, actionable discussions. The individual will proactively identify unmet educational needs, deliver non-promotional scientific support, and play a key role...

Position Certified Professional Coder / Bill Review Expert Location Remote Employment Details FMLA: Non-Exempt, Full-Time Schedule: M-F 8:00 AM - 4:30 PM Must Have PIP experience with a high level understanding of fee schedule guidelines in NY, NJ, FL, or MI required. CPC in good standing with AAPC required (may consider candidate with strong PIP experience, e.g., NJ/NY PIP adjuster). Responsibilities Use various resources to support reviews, such as CPT guidelines, CPT Assistant, Encoder Pro, and 3M Software. Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and/or NY-covered insureds. Interpret medical documentation to ensure accuracy of billed services (e.g., CPT, HCPC codes). Assign proper CPT and HCPC codes based on the review outcome. Review CPT codes for unbundled services. Review billed modifiers for accuracy of use. Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement. Interpret fee schedule...

Urgent Requirement - Certified Professional Coder Full-time Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right...

A leading company in strategic workforce solutions is seeking a Certified Professional Coder in Ewing, NJ. The role entails reviewing and translating medical policies and legislative mandates into accurate coding using CPT-4, HCPC, and ICD-9/ICD-10 standards. The successful candidate will have a clinical background, coding certifications, and several years of experience in medical coding and health insurance claims processing. #J-18808-Ljbffr

Driven by a bold pursuit of science and fueled by an unwavering commitment to patients, Sun Pharma is a leading global pharmaceutical company, providing high-quality medicines trusted by healthcare professionals and patients. As part of our mission to Reach People and Touch Lives, we deliver Innovative Medicines, Generics and Consumer Healthcare products that improve the lives of millions of people. With a broadly diversified portfolio of products that span multiple therapeutic areas, we improve access to effective, affordable treatments that promote better health and well-being. Reaching People. Touching Lives. Job Summary Sun Pharma is seeking a strategic and dynamic Associate Director, Marketing (DTC & HCP) - Medical Dermatology to serve as a key leader within the U.S. Medical Dermatology Marketing organization. This position reports to the Senior Director, Marketing – Medical Dermatology and the work location is Princeton, NJ (3 days in the office per week). This role...

We Are TevaWe’re Teva, a leading innovative biopharmaceutical company, enabled by a world-class generics business. Whether it’s innovating in the fields of neuroscience and immunology or delivering high-quality medicine worldwide, we’re dedicated to addressing patients’ needs now and in the future. Here, you will be part of a high-performing, inclusive culture that values fresh thinking and collaboration. You'll have the room to grow, the flexibility to balance life with work, and the opportunity to better health worldwide, together.Our Team, Your ImpactThis position is responsible for developing and implementing HCP medical education strategies for CNS (Movement Disorder / Tourette Syndrome / Bipolar / Schizophrenia) brand at Teva. The position will ensure educational needs are being identified, addressed, and appropriately prioritized for this brand and across the portfolio. The individual in this role will leverage their expert understanding of medical education initiatives in...