15 hcc risk 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...

Sentara Medical Group in Virginia Beach, VA is seeking a full-time hybrid Risk Adjustment Coder to ensure accurate CMS/HHS risk adjustment documentation. The role blends remote and in-office work, with 1-2 days on site weekly and travel as needed to support team objectives. The position requires 1 year Medical Records Data experience and 2 years Coding experience, plus certification options including CPC/COC/CIC etc. #J-18808-Ljbffr

Become a part of our caring community Become a part of our caring community and help us put health first *** $5,000 SIGN-ON BONUS for new associates! $5,000 payable following 90 days employment. *** The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding...

Become a part of our caring community We are looking for a consultative coding professional to provide medical coding expertise and support to IPA affiliates nationwide. The IPA Consultative Coding Professional will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. They will analyze trends, triage, answer questions in real‑time, research and interpret coding guidelines, and respond to inquiries and issues. Assignment will include a panel of up to 30 providers within a defined market or region. The professional will deliver ongoing education, support coding workflows, and ensure agreement on documentation and coding standards, while collaborating with STARS leaders and champions to identify gaps and deficiencies. They will support IPA‑affiliated clinicians—physicians and advanced practice providers—to ensure documentation supports accurate diagnostic coding...

Job Title Risk Coder Location Virginia Beach, VA Work Shift First (Days) Job Description Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality...

## Risk Adjustment CoderApplyremote type: Hybridlocations: SMG Administrationtime type: Full timeposted on: Posted Todayjob requisition id: JR-103351**City/State**Virginia Beach, VA**Work Shift**First (Days)**Overview:**# **Overview**Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training,...

Risk Adjustment CoderSentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!Hours: Monday - Friday, 8:00AM -5:00PM, dayshift.This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration.Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical...

Sentara Health Plans in Virginia Beach, VA is seeking a Risk Adjustment Coder to perform compliance activities related to CMS/HHS risk adjustment and RADV audits. You will review professional and facility coding to ensure accurate HCC capture and support vendor and internal audits. The role requires an Associate degree or 4 years of coding experience, knowledge of ICD-10-CM guidelines, and CRC certification within two years. #J-18808-Ljbffr

As a member of the Amazon One Medical Senior Health Revenue Cycle team, the Medical Coder I will be responsible for supporting Clinical and Revenue Cycle teams in reviewing the coding accuracy of claims. This role reports into the Manager I, Finance. As part of Amazon Health Services, you will find yourself working with exceptionally talented and dedicated people committed to driving financial improvement, scalability, and process excellence. To support our growth, this candidate must possess a strong passion for accountability, setting high standards, raising the bar, and driving results through constant focus on improving existing and future state operations, systems, and processes in collaboration with management. Key job responsibilities Managing multiple coding related projects and ensuring deliverables are up to One Medical standards while being turned around in an acceptable time frame Remaining current on CPT, ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and CMS...

Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA! Hours: Monday - Friday, 8:00AM -5:00PM, dayshift. This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration. Overview Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record...

IPA Consultative Coding Professional Become a part of our caring community and help us put health first *** $5,000 SIGN-ON BONUS for new associates! $5,000 payable following 90 days employment. ***The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and...

General Position Summary: The Medical Coding Specialist works as part of the Billing & Coding Department to review clinical documentation, abstract data from patient medical records, and accurately assign diagnosis and procedure codes in accordance with applicable coding guidelines and regulatory requirements.   Essential Duties and Responsibilities:   1.      Reviews patient medical records and assigns diagnosis and procedure codes in accordance with ICD-10-CM, CPT, HCPCS, and applicable coding guidelines. 2.      Ensure compliance with federal, state, payer, and organizational coding regulations and policies. 3.      Assigns and sequences diagnosis and procedure codes accurately for all services rendered. 4.      Ensures documentation and coding accurately reflect services provided and support quality reporting metrics. 5.      Identifies missed diagnoses, chronic conditions, and documentation deficiencies that may...

Hospital Inpatient Coding SpecialistThe Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR-DRG) or Medical Severity Diagnosis Related Group (MS-DRG) for optimal reimbursement. The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra's coding policies. The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information.ResponsibilitiesAssigns diagnosis and procedure codes.Verifies accuracy of DRGAccurately abstracts required...

Sentara Health is seeking a Risk Coder to perform compliance activities focused on CMS and HHS risk adjustment. You will review provider coding, support RADV audits, and ensure accurate ICD-10-CM coding to capture appropriate HCCs. The role requires an associate degree or equivalent coding experience, proficiency in ICD-10-CM, and CRC certification within two years. Experience with CMS/HHS RADV is preferred. #J-18808-Ljbffr

Hospital Inpatient Coding Specialist The Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR-DRG) or Medical Severity Diagnosis Related Group (MS-DRG) for optimal reimbursement. The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra's coding policies. The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information. Responsibilities Assigns diagnosis and procedure codes. Verifies accuracy of DRG Accurately abstracts...