18 hcc risk adjustment coder jobs found

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting. Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence. #J-18808-Ljbffr

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting. Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence. #J-18808-Ljbffr

Blue Cross Blue Shield of Arizona is seeking a Coder Specialist to perform medical record reviews and abstract the highest specificity codes for CMS risk adjustment. The role supports accurate risk adjustment factors used in payment determinations and requires a certified medical coder with ICD-9/ICD-10 knowledge. The position is 70% remote with travel to the office or to visit network providers for education and meetings. #J-18808-Ljbffr

Blue Cross Blue Shield of Arizona is seeking a Coder Specialist to perform medical record reviews and abstract high-specificity codes from documentation to support CMS risk adjustment. The role requires 3 years of coding experience, CPC/CPC-I or similar certification, and a full-time hybrid schedule with remote work about 70% and periodic onsite meetings. The ideal candidate will maintain HIPAA compliance, communicate effectively with care provider offices, and keep up with ICD-9/ICD-10 coding #J-18808-Ljbffr

Purpose Of The JobThe Coder Specialist is to perform medical record reviews and abstract highest specificity codes effectively from medical records based on the documentation provided. This data is sent to CMS to determine accurate risk adjustment factor used to adjust payments for members' future healthcare cost. Medical record reviews will be retrospective and must be conducted by a certified medial coder. Codes will be sequenced and assigned by documentation in the medical record which most accurately describes each documented diagnosis. The coder is responsible for ensuring diagnosis codes selected come from a face to face visit with a valid Risk Adjustable provider. The diagnosis must be coded according to International Classification of Diseases (ICD) version 9 or 10 depending on date of service for coding and reporting.Essential Job Functions And ResponsibilitiesComprehensive understanding of Coding guidelines/rules, regulations and methodologyAccurately and efficiently...

Required Skills & Experience Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) Strong ICD-10-CM coding experience and medical record review background Knowledge of Risk Adjustment and HCC coding methodologies Experience reviewing physician documentation and assigning accurate diagnosis codes Strong understanding of medical terminology, anatomy, physiology, and disease processes Ability to interpret complex clinical documentation with high accuracy and productivity Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience Medicare Advantage Risk Adjustment experience Experience working with CMS-HCC models CRC (Certified Risk Adjustment Coder) certification Experience with EMRs and coding software platforms Background in a health plan, physician practice, hospital, or revenue cycle environment Audit and quality assurance experience Job Description Insight Global is seeking Medical Coders specializing in Risk...

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost. The HCC Coder II is a highly organized, team-oriented individual who possesses the ability to quickly understand and carry out verbal and written directions and can efficiently multi-task and work on special projects in addition to regular review of outpatient and inpatient charts. The Coder II will be responsible for identifying and...

Arizona Priority Care in Chandler, AZ seeks a Coder II to identify and report HCC diagnoses from chart reviews across outpatient and inpatient settings. The role emphasizes accurate ICD-10 coding, CMS STAR support, and collaboration within a team. The candidate should hold AHIMA/AAPC certification with 2 years HCC coding experience, and be comfortable with Excel/Word. A 60-day in-office presence is required; hybrid options may follow. #J-18808-Ljbffr

Are you an experienced outpatient coder ready for something more? We’re looking for an OutpatientCDS/Coder to join our Valleywise Health CDI team. This is a unique hybrid role designed for an experienced outpatient coder who wants to expand their skills into Clinical Documentation Integrity while continuing to perform production coding . You’ll build on your coding expertise through clinical documentation review, compliant query generation, provider education, risk adjustment, and documentation improvementwhile still coding and staying connected to the work you know. Strong outpatient coding experience is the foundation. We’ll help you grow the CDI side. Valleywise Health is committed to providing high-quality, comprehensive benefits designed to help our employees and their families stay physically and financially fit. Known for the diversity of not only the community of patients we serve but also our workforce and the benefits we offer, such as: Medical,...

Purpose Of The Job The Coder Specialist is to perform medical record reviews and abstract highest specificity codes effectively from medical records based on the documentation provided. This data is sent to CMS to determine accurate risk adjustment factor used to adjust payments for members' future healthcare cost. Medical record reviews will be retrospective and must be conducted by a certified medial coder. Codes will be sequenced and assigned by documentation in the medical record which most accurately describes each documented diagnosis. The coder is responsible for ensuring diagnosis codes selected come from a face to face visit with a valid Risk Adjustable provider. The diagnosis must be coded according to International Classification of Diseases (ICD) version 9 or 10 depending on date of service for coding and reporting. Essential Job Functions And Responsibilities Comprehensive understanding of Coding guidelines/rules, regulations and methodology Accurately and...

Purpose Of The Job The Coder Specialist is to perform medical record reviews and abstract highest specificity codes effectively from medical records based on the documentation provided. This data is sent to CMS to determine accurate risk adjustment factor used to adjust payments for members' future healthcare cost. Medical record reviews will be retrospective and must be conducted by a certified medial coder. Codes will be sequenced and assigned by documentation in the medical record which most accurately describes each documented diagnosis. The coder is responsible for ensuring diagnosis codes selected come from a face to face visit with a valid Risk Adjustable provider. The diagnosis must be coded according to International Classification of Diseases (ICD) version 9 or 10 depending on date of service for coding and reporting. Essential Job Functions And Responsibilities Comprehensive understanding of Coding guidelines/rules, regulations and methodologyAccurately and efficiently...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified...

Are you an experienced outpatient coder ready for something more? We're looking for an Outpatient CDS/Coder to join our Valleywise Health CDI team. This is a unique hybrid role designed for an experienced outpatient coder who wants to expand their skills into Clinical Documentation Integrity while continuing to perform production coding . You'll build on your coding expertise through clinical documentation review, compliant query generation, provider education, risk adjustment, and documentation improvement while still coding and staying connected to the work you know. Strong outpatient coding experience is the foundation. We'll help you grow the CDI side. Valleywise Health is committed to providing high-quality, comprehensive benefits designed to help our employees and their families stay physically and financially fit. Known for the diversity of not only the community of patients we serve but also our workforce and the benefits we offer, such as: Medical,...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims...

Description Position Summary: The Certified Coder is a key position in two ways: First, the employee will be responsible for abstracting medical record data and assigning/reviewing codes using current clinical classification systems appropriate for the type of care provided. Second, the employee will be able to review Medicare Risk Adjustment, understanding Medicare Advantage Plans and evaluating medical records with attention to detail. Requirements Essential Functions 1. Reviewing and assigning codes to diagnosis and procedures in order to ensure proper financial reimbursement from insurance companies. Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests. Assists facility staff with documentation requirements to completely and accurately reflect the patient care provided. Conducts claims audits/reviews, identifying opportunities for improving. 2. The Certified Coder is responsible for...

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...