4 hcc risk adjustment coder jobs found

Risk Adjustment Coding AuditorOverview We are seeking a detail-oriented Risk Adjustment Coding Auditor to support the accuracy, integrity, and compliance of clinical coding data across risk adjustment programs. In this role, you will conduct audits, review medical record documentation, identify coding opportunities, and provide guidance on coding accuracy to help support compliant reporting and appropriate reimbursement. The ideal candidate will bring extensive HCC coding and risk adjustment auditing experience, strong analytical skills, and a thorough understanding of Medicare, Medicaid, and ACA risk adjustment models. Key Responsibilities Perform retrospective and prospective chart reviews to evaluate risk adjustment diagnosis coding accuracy. Audit medical records to verify the completeness, specificity, and appropriateness of reported diagnoses. Review clinical documentation to ensure accurate HCC capture and risk adjustment reporting. Evaluate...

Spectraforce Technologies seeks a Quality Assurance Coder/Auditor to lead risk adjustment coding quality within Medicare/Medicaid programs. You will review records, perform audits, and educate providers on accurate diagnoses and documentation to improve coding accuracy. This hybrid Phoenix role requires travel to physician offices weekly, a minimum of 5 years of medical coding with HCC experience, and CCS-P/CRC/CPC/COC credentials. The position is 6 months with potential extension. #J-18808-Ljbffr

Job Title: Quality Assurance Coder/Auditor Location: Phoenix, AZ (Hybrid, Required to Travel into the office 1 x per week) Duration: 6 Months (possibility of extension or conversion) Department: Medicare/ Medicaid Purpose The Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. On a regular basis, the Coder/Auditor will educate primary care providers and their staff on their historical diagnoses/coding error trends, accurate completion of medical record documentation, and at‑risk code identification and risk mitigation. This includes the review, analysis, and recommended coding based on medical and clinical diagnoses, procedures, injuries, or illnesses contained in medical records and supporting documentation. The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at‑risk single occurrences of HCCs and OIG targets. Deletions will be submitted for unsupported/invalid diagnoses....

Job DescriptionJob DescriptionAbout Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.Optima is currently seeking a HCC Risk Coder Specialist to join our team.As the Risk Adjustment Coder you will perform medical record diagnosis code abstraction based upon clinical documentation, ICD-10-CM official...