7 risk adjustment medical coder jobs found

Job Description - Pro Fee Coder - Hospitalist The Pro Fee Coder - Hospitalist will review clinical documentation to assign and sequence diagnostic and procedural codes for hospital-based inpatient and observation encounters to meet the requirements of physician billing and reimbursement. This role focuses on professional fee (pro-fee) coding for hospitalists, ensuring accurate Evaluation & Management (E/M) coding for initial, subsequent, and discharge visits, as well as compliant documentation to support medical necessity and coding integrity. The Coder performs documentation review and assessment for accurate abstracting of clinical data and may interact with providers and clinical staff for clarification and education. DUTIES AND RESPONSIBILITIES: Select and assign ICD-10-CM and CPT/HCPCS codes for hospitalist services, including: Initial hospital care Subsequent daily visits Discharge management Observation and admission-to-discharge same-day...

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. Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be...

Overview Job Description - Pro Fee Coder – Hospitalist The Pro Fee Coder – Hospitalist will review clinical documentation to assign and sequence diagnostic and procedural codes for hospital-based inpatient and observation encounters to meet physician billing and reimbursement requirements. This role focuses on professional fee (pro-fee) coding for hospitalists, ensuring accurate Evaluation & Management (E/M) coding for initial, subsequent, and discharge visits, as well as compliant documentation to support medical necessity and coding integrity. The Coder performs documentation review and assessment for accurate abstracting of clinical data and may interact with providers and clinical staff for clarification and education. Duties and Responsibilities Select and assign ICD-10-CM and CPT/HCPCS codes for hospitalist services, including: Initial hospital care Subsequent daily visits Discharge management Observation and admission-to-discharge same-day encounters Critical...

A leading health insurance company is seeking a Senior Specialist in Risk Adjustment to manage operations for Medicare Advantage and ACA lines of business. This remote position requires a bachelor's degree and certifications in coding, alongside at least two years of relevant experience. Key responsibilities include daily operations, compliance with standards, and participation in audits. The position comes with a competitive salary range and extensive employee benefits including medical and dental coverage, paid leave, and a 401(k) plan. #J-18808-Ljbffr

About the role The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. Pay Transparency The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities Responsible for daily operations pertaining to Risk...

Lead Medical Coder and Auditor ProSidian Consulting is looking for a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military operations and the spectrum of conflict, in support of combatant commanders". The Regional Health Command's Readiness Mission includes dental care of active duty Soldiers, public health services, veterinary services, and providing management and support to wounded, ill and injured Soldiers assigned to its seven warrior transition units. The ProSidian Engagement Team Members work to provide health...