24 hcc risk coder jobs found

Astrana Health seeks a Risk Adjustment Coding Specialist II to join our Strategy and Operations team in Monterey Park, CA. The role requires converting provider documentation into compliant HCC coding and educating providers on CMS requirements while traveling to provider sites as needed. Qualified candidates hold CCS/CPC certification with 3+ years of risk adjustment coding experience, strong EHR skills, and the ability to work in a hybrid setting, including on-site visits and remote #J-18808-Ljbffr

NECC is seeking a detail‑oriented HCC Coder to ensure accurate outpatient coding and documentation. You will work with Billing and Medical Director to apply ICD-10-CM, CPT, HCPCS and HCC guidelines, promoting quality measures and risk adjustment accuracy. You will review records for accuracy, educate staff on Medicare rules, and lead coding process improvements, with travel up to 10% for facility coverage as needed. #J-18808-Ljbffr

Astrana Health in Monterey Park, CA is seeking a Risk Adjustment coder to review and ensure accurate ICD-10-CM/HCC documentation across Medicare Advantage, ACA, and commercial lines. You will educate providers and work with IPAs to improve coding quality. You will travel up to 75% and balance on-site fieldwork with hybrid support, maintaining up-to-date knowledge of CMS guidelines and payer requirements while meeting productivity targets. #J-18808-Ljbffr

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. Ensure all...

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,...

A healthcare organization in California is seeking a Medical Coder to perform chart reviews, coding audits, and provide training on ICD-10 codes. The ideal candidate will have an AA or AS degree, relevant coding credentials, and two years of healthcare experience. Responsibilities include coding audits, maintaining knowledge of coding guidelines, and assisting with billing inquiries. This role offers competitive benefits including free medical, dental, and vision insurance. #J-18808-Ljbffr

Medical CoderAt Sprinter Health, our mission is reimagining how people access care by bringing it directly into their homes. Nearly 30% of patients in the U.S. skip preventive or chronic care simply because they can't get to a doctor's office. For many, the ER becomes their first touchpoint with the healthcare system—driving over $300B in avoidable costs every year.By using the same technologies that power leading marketplace and last-mile platforms, we deliver care where people are, especially those who need it most. So far, we've supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS. Our team of clinicians, technologists, and operators have raised over $125M to date from investors like a16z, General Catalyst, GV, and Accel and enjoy multi-year runway.As a Medical Coder, you will be responsible for reviewing and abstracting professional medical records to ensure accurate code assignment. You'll play a critical role...

The Medical Coder is primarily responsible for performing chart reviews and coding audits; reviewing appropriate ICD-10 diagnoses codes, and CPT and HCPCS procedure codes assigned for evaluation and management of the patient. Additional responsibilities include supporting pre-or post-payment coding audit for benchmark and/or reimbursement recovery, and other coding-related activities such as pre-appointment chart audits for HCC or risk adjustment, appeals of denied claims, providing information or education to providers for specificity of documentation to align with the coding guidelines to comply with federal, state, and regulatory requirements. ESSENTIAL JOB FUNCTIONS: Performs pre-appointment HCC or risk adjustment chart reviews, coding audits, or other coding-related projects Acts as internal resource for all coding inquiries from providers, Billing, Laboratory, Radiology, and other departments. Provides real time coding consultation and review and evaluation of...

Astrana Health is seeking a Risk Adjustment Coding Specialist to support Orange County operations. You will conduct high-volume chart reviews to identify coding gaps, then translate findings into education for providers and practice leaders, driving HCC recapture and KPI improvements. olla You will travel to provider offices up to 75% and collaborate with IPA teams, offering auditing and education to ensure CMS, Medicare and payer guidelines are met while staying current on ICD-10/HCC updates. #J-18808-Ljbffr

JOB DESCRIPTION Job SummaryProvides 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 business by providing coding assistance as...

Senior Specialty Physician Coder – InterventionalOur client, a healthcare company, is looking for a Senior Specialty Physician Coder – Interventional for their Fountain Valley, CA location.Responsibilities:Achievement of productivity standards as established by management.Achievement of quality standards as established by management. In adherence with standard work, analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines, including the ability to review and natively code surgical operative and/or procedure reports.In adherence with standard work, follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements.Participate in developing, implementing, and reviewing programs for coding compliance...

Astrana Health, Inc. in Monterey Park, CA is seeking a Risk Adjustment Coding Specialist II to verify provider documentation, educate providers, and support CMS risk adjustment initiatives. The role requires travel to provider sites (about 75%) and reports to the Supervisor - Risk Adjustment. Requires CCS/CPC or similar certification and 3+ years of risk adjustment coding, with strong ICD-10-CM/HCC knowledge and EHR proficiency. Competitive salary is $75,000–$85,000 per year. #J-18808-Ljbffr

Risk Adjustment Coding AuditorHuntington Beach Office - Huntington Beach, CA 92647OverviewSalary Range $72,800.00 - $80,000.00 Salary Position Type Full TimeDescriptionAre you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members' culture and values.Why Join Us? We're on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.Job SummaryThe Risk Adjustment Coding...

Job Description The HCC Coder will be responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted and established standards. The HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services. Schedule Full-time (Non-Exempt) Flexible, may require some evening and weekends Primary Duties and Responsibilities Review of medical records to ensure accuracy and claims for proper documentation and coding and completeness. Communicate with providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes. Create training presentations to educate staff in Medicare coding guidelines, with focus on Quality Measures...

HCC CoderAdministration Office - Alhambra, CA 91801OverviewSalary Range $34.00 - $39.00 HourlyDescriptionPosition SummaryThe HCC Coder will be responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted and established standards. The HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services.Schedule:Full-time (Non-Exempt)Flexible, may require some evening and weekendsPrimary Duties and ResponsibilitiesReview of medical records to ensure accuracy and claims for proper documentation and coding and completeness.Communicate with providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.Create training...

Certified Risk Coder Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Compensation: $56,000 - $85,000 / year Description The Certified Risk Coder plays a critical role in supporting Astrana Health's value-based care and risk adjustment initiatives by ensuring the accurate capture and validation of diagnoses through comprehensive medical record review and coding analysis. This position partners closely with providers and clinical teams to improve documentation quality, coding accuracy, and compliance with CMS risk adjustment guidelines. The ideal candidate brings strong coding expertise, a passion for provider education, and a commitment to enhancing organizational performance through accurate risk capture, regulatory compliance, and continuous process improvement. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity &...

Medical Coder At Sprinter Health, our mission is reimagining how people access care by bringing it directly into their homes. Nearly 30% of patients in the U.S. skip preventive or chronic care simply because they can't get to a doctor's office. For many, the ER becomes their first touchpoint with the healthcare systemdriving over $300B in avoidable costs every year. By using the same technologies that power leading marketplace and last-mile platforms, we deliver care where people are, especially those who need it most. So far, we've supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS. Our team of clinicians, technologists, and operators have raised over $125M to date from investors like a16z, General Catalyst, GV, and Accel and enjoy multi-year runway. As a Medical Coder, you will be responsible for reviewing and abstracting professional medical records to ensure accurate code assignment. You'll play a critical...

HCC Coder Administration Office - Alhambra, CA 91801 Overview Salary Range $34.00 - $39.00 Hourly Description Position Summary The HCC Coder will be responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted and established standards. The HCC Coder will collaborate with the Billing Manager and Medical Director in providing expertise in the use and application of current coding classifications including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient diagnoses and services. Schedule: Full-time (Non-Exempt) Flexible, may require some evening and weekends Primary Duties and Responsibilities Review of medical records to ensure accuracy and claims for proper documentation and coding and completeness. Communicate with providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for...

Job Description Job Description The Certified Cardiology Coder plays a critical role in accurately translating cardiology medical records into standardized codes used for billing and documentation. This position requires expertise in cardiology procedures and coding standards to ensure compliance and data integrity. The coder works closely with clinicians and utilizes specific coding software alongside manual coding processes to support effective claims processing and reporting.   Responsibilities Assign accurate codes based on cardiology medical records Review and audit medical records for coding compliance Ensure data accuracy and adherence to coding guidelines Generate reports related to coding and billing activities Analyze patient data for completeness and coding accuracy Conduct coding audits to identify discrepancies and improve processes Collaborate with clinicians to clarify documentation and coding queries Process claims efficiently to support timely...

1.0 FTE Full time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding Compliance Educators to address compliance issues. They are responsible for conducting...

Coding Compliance AuditorRiverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department.Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff.The ideal candidate will have at least five years of progressive experience in an...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key Responsibilities Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. Ideal Candidate The ideal candidate will have at least...