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6 risk adjustment coder jobs found

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risk adjustment coder Intermediate Level
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C2Q Health Solutions
Full Time
 
Medical Coding and Billing Analyst
C2Q Health Solutions Hybrid (NY)
JOB PURPOSE: Responsible for supervising, evaluating, and consistently improving the day-to-day operations of Medical Practice. This role is responsible for accurate and timely billing of insurance claims and patient statements across multiple sites, implements accurate medical coding policies, and enhances operational processes. It involves acting as a liaison between coding operations and clinical staff, training and coaching medical personnel on coding guidelines, and ensuring the accuracy and timeliness of clinical documentation. Additionally, the role includes analyzing and optimizing diagnosis data submission processes, presenting performance results to leadership, and supporting HCC/RAF optimization strategies. The role will also oversee the training of Medical Practice Assistants, Physician and IDT disciplines in ICD-9/ICD-10 guidelines. JOB RESPONSIBILITIES: Responsible to deliver accurate and timely billing of insurance claims and patient statements for all...

Apr 15, 2026
Maryland Primary Care Physicians
Full Time
 
Certified Coder- Primary Care
Maryland Primary Care Physicians Hybrid (MD)
Position Summary:   The Certified Medical Coder is responsible for reviewing patient medical records and accurately assigning diagnosis and procedure codes using ICD, CPT, and HCPCS classification systems. This role ensures compliance with regulatory guidelines, supports timely claims submission, and collaborates with clinical and billing staff to maintain coding accuracy and completeness. Reports to:   Coding Director Supervisory responsibilities : None Key Responsibilities include but not limited to: Assign accurate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS systems Review and abstract medical record documentation, including chronic conditions and quality measures  Ensure proper code sequencing in compliance with federal regulations and payer requirements  Validate that documentation supports all coded diagnoses, procedures, and charges  Identify and resolve documentation gaps; query providers for clarification when needed...

May 13, 2026
Virtix Health
Seasonal/Temporary
 
HCC Coding Specialist (Temporary, FT and PT available)
Virtix Health Remote
Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Risk Adjustment Coding Specialists are an important part of the Team at Virtix Health. The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Equipment provided along with Encoder software with access to AHA Coding Clinic This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:...

May 21, 2026
Nemours Children's Health
Full Time
 
Facility ED Coder - 18553
Nemours Children's Health Remote (Orlando, FL)
Job Description Join our team as a Facility ED Coder! Role responsibilities include assessing documentation for each service rendered in the hospital’s place of service, in order to accurately code principal diagnoses (i.e. preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida’s enhanced ambulatory grouping.  This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges),working knowledge of revenue codes, relevant grouper function and financial impact;  assessment and entry of surgical charges (i.e. supplies, implants), and pharmacy charges (i.e. contrast, patient supplied, etc).   This position is remote. Applicants must...

Apr 30, 2026
Nemours Children's Health
Full Time
 
Outpatient Surgical and Observation Coder - 18315
Nemours Children's Health Orlando, FL
Job Description Join our team as a Remote Outpatient Surgical and Observation Coder ! Role responsibilities include assessing documentation for each service rendered in the hospital’s place of service, in order to accurately code principal diagnoses (i.e. preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida’s enhanced ambulatory grouping.  This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges),working knowledge of revenue codes, relevant grouper function and financial impact;  assessment and entry of surgical charges (i.e. supplies, implants), and pharmacy charges (i.e. contrast, patient supplied, etc).   This is...

Apr 28, 2026
Northwest Permanente
Full Time
 
Documentation and Coding Consultant 1
Northwest Permanente Hybrid
Overview: The Documentation and Coding Consultant 1 provides training, consultation, review, and feedback to clinicians on their medical service documentation and coding to ensure KPNW receives appropriate reimbursement and conforms to applicable guidelines and regulations. This is a hybrid position that is a blend of working both remotely and in office. Must reside in the Northwest Service Region (Oregon or Washington). Major Responsibilities / Essential Functions: Consulting and Coding services Provides expert consultation to specialists or primary care clinicians as assigned on coding and documentation education and questions. Within assigned clinical specialties, maintain current knowledge to ensure that KPNW coding and documentation meets regulatory guidelines and audit standards. Follow coding specificity guidelines using coding rules and guidelines. General coding knowledge and understanding of Risk Adjustment models and submission...

May 20, 2026
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