29 hcc risk adjustment coder jobs found

A leading healthcare provider in Texas is seeking an experienced Value Based Coder II to review medical records for coding opportunities, focusing on Hierarchical Condition Categories (HCC). The role involves developing provider education and ensuring compliance with coding guidelines. Candidates should have a Bachelor's degree in healthcare or equivalent experience, CPC/CCS/CRC certification, and at least 2 years of outpatient coding experience. Competitive hourly pay ranges from $25.30 to $35.74. #J-18808-Ljbffr

St Luke's Health is looking for a Value Based Coder II in Houston, Texas. This role involves reviewing patient medical records to enhance coding opportunities with a strong emphasis on Hierarchical Condition Categories (HCC). The ideal candidate will have 2+ years in outpatient coding and a deep understanding of risk adjustment principles. Responsibilities include providing education to network providers and ensuring compliance with coding guidelines. #J-18808-Ljbffr

Direct Jobs is seeking a Risk Adjustment Coder II in Houston, Texas. This role involves advanced support for medical record reviews, ensuring correct capture of chronic conditions and compliance with CMS guidelines. The Coder II acts as a subject matter expert, facilitating team training and audits. The ideal candidate will have a Bachelor's degree or equivalent experience in risk adjustment, along with relevant coding certifications. Experience in Commercial and Medicare coding is required alongside strong analytical and communication skills. #J-18808-Ljbffr

RN Field Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The RN Field Coder will be responsible for documentation and coding review of medical records where...

Exciting Opportunity For Medical Coding Specialist at University Health in San Antonio!.Are you ready to make an impact in healthcare and be part of a nationally recognized, top-tier health system? Full-time Orthopedic sports medicine physician practice looking for a highly motivated individual to join our team as a Certified Medical Biller and Coder (Surgical).DUTIES INCLUDE, BUT ARE NOT LIMITED TO:.M Full-time Note : This is an educational program, not a job.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Looking to Full-time Quick Apply As we continue to grow, we are seeking an experienced and committed Insurance Specialist to join our Fast-Paced team.If you want to be a part of a winning and competitive culture, then this may be Full-time As a Cleaning Specialist, you will be responsible for cleaning and maintaining facilities, including: clean and sanitize designated areas.Duties and...

Certified Medical Coder Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system Selects and accurately records all appropriate records and data on assigned chart abstraction projects Ability to meet productivity and accuracy requirements Performs other duties as assigned Qualifications High School Diploma or GED required A certification in one of the following is required: Certified...

Value Based Coder II Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk‑adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently 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 and HCC. Validate the accuracy and completeness of HCC documentation and coding. Advanced...

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: 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more Job Description These are a 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. Assign appropriate...

Job Title Submission Requirements AAPC certificate required; MUST be CPC, CPC-H and/or COC - REQUIRED Must have graduated from an approved coding program or health information management program - REQUIRED Proficiency in AT LEAST 3 of the following: Specialty Clinics (Med Spec Inject, Anticoag Management, Nutrition/Oncology Nutrition, Newborn/Lactation, OP Orthotic Prosth, Urology, Apheresis, Cardiac Rehab, General Surgery, Int Pain Healing, Non Inv Cardiology, Outpatient General Surgery, Proctology, Plastic Surgery, Endocrine, Benign Gyn, Infectious Disease, Neurosurgery, Oral & Facial Surgery, Ortho Total Joint, RAD CT, RAD MRI, RAD MRI, Trauma, Amputation Clinic, Burn Clinic, Dermatology, Endocrine Surgery, ENT Clinic, GI and Liver Disease, Gyn Dysplasia, Internal Medicine, Mineral Metabolism, Ortho Foot & Ankle, Pain, Burn Outpatient, Hand Surgery, Cardiology, Comprehensive Wound, Neurology, Pulmonology Clinic, Rheumatology, Eye Clinic, Access Clinic) - REQUIRED...

Job Summary The RN Field Coder will be responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. The RN Field Coder will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work includes pre-visit, post-visit, and wrap‑around education. In pre‑visit, the coder reviews medical records, outside results, and health plan data for upcoming appointments, flagging key insights for the provider. In post‑visit, the coder reviews the provider note, populates all supported codes (ICD‑10, CPT, CPT‑II, etc.), and assists in claim submission. Wrap‑around education involves periodic review of findings, highlighting documentation opportunities, and ongoing education. The Field Coder is responsible for provider querying and education on documentation guidelines, requires a strong understanding...

Job Summary The RN Field Coder will be responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. The RN Field Coder will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work supported by the RN Field coder will include pre, post and wraparound visit input. Pre-Visit: Reviewing the medical records, outside results and health plan data for upcoming patient appointments and flagging important insights for the provider to review before seeing the patient. Post Visit: Reviewing the provider note, populating all supported codes (ICD-10, CPT, CPT-II, etc.), and assisting submission of encounter for claim processing. Wrap Around Education: Periodic review of findings, highlighting areas of opportunity in documentation and ongoing education. Provider querying and education...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently 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 and HCC. Validate the accuracy and completeness of HCC documentation and coding. Advanced...

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary The RN Field Coder will be responsible for documentation and coding review of...

Prominence Health is seeking an RN Field Coder to review and code medical records across partner practices, ensuring accurate diagnoses and service codes to support risk adjustment and quality measurement. The role involves pre-visit record review, post-visit coding, provider education, occasional onsite work, and potential out-of-state travel. Strong CMS HCC guidelines knowledge, CPC/CRC credentials, and English proficiency are required; Spanish a plus. #J-18808-Ljbffr

RN Field Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The RN Field Coder will be responsible for documentation and coding review of medical records where...

RN Field Coder The RN Field Coder will be responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. The RN Field Coder will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work supported by the RN Field coder will include pre, post and wraparound visit input. Pre-Visit: Reviewing the medical records, outside results and health plan data for upcoming patient appointments and flagging important insights for the provider to review before seeing the patient. Post Visit: review the provider note, populate all supported codes (ICD-10, CPT, CPT-II, etc.), and assist submission of encounter for claim processing. Wrap Around Education- periodic review of findings, highlighting areas of opportunity in documentation and ongoing education. The Field Coder will be responsible for...

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The RN Field Coder will be responsible for...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via...

Certified Medical Coder Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system Selects and accurately records all appropriate records and data on assigned chart abstraction projects Ability to meet productivity and accuracy requirements Performs other duties as assigned Qualifications High School Diploma or GED required A certification in one of the following is required:...

Medical Coder – Multi-Specialty (Hospital & Clinic) Location: Kingwood or Remote Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing certified medical coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM,...

Medical Coder - Multi-Specialty (Hospital & Clinic) Location: Kingwood or Remote Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: • Cardiology • Urology • Dermatology • General Surgery • Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review • Accurately assign...

Job Description REMOTE position WebEx video interview will be conducted prior to an offer MUST be able to work 40 hrs/week without issue Applicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera. If not, Agency must supply ahead of start date. Knowledge and Expertise: Must demonstrate a solid understanding of Coding Guidelines and CPT Guidelines for E/M (Evaluation and Management). Must be able to answer questions to gauge their coding knowledge. Clinic Coding Experience: Must have experience in clinic coding, including: Office-type procedures Vaccinations E/M leveling Modifiers: Familiarity with modifiers used in the clinic setting is essential. Risk Adjustment Experience: While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding experience as well. Experience in Specialty Areas: The candidate must have experience in at...

Risk Adjustment Coder II The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. Job Specifications and Core Competencies: Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...