42 ambulatory risk adjustment coder jobs found

AltaMed Health Services Corp. is seeking a Risk Adjustment Coder to perform concurrent, prospective, and retrospective reviews of ambulatory medical records to ensure accurate capture of illness severity and complexity. The role involves evaluating coded data quality and compliance with federal, state, and county regulations for risk adjustment models. The position requires a high school diploma, at least 2 years of risk adjustment coding/auditing experience, and proficiency with multiple #J-18808-Ljbffr

Endeavor Health in Skokie, IL seeks an Ambulatory Risk Adjustment Coding Specialist to identify and code HCCs in outpatient visits, ensuring documentation supports CMS risk scores. This role collaborates with ambulatory CDS and physicians to validate codes and improve documentation and coding accuracy. The position requires a High School diploma, CRC certification within six months, and 2 years in healthcare. #J-18808-Ljbffr

Medical Coder Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure...

This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. University Health Networ k is seeking a full-time Certified Medical Coder to join our team. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding HCC diagnoses using ICD-10-CM guidelines. CPT and E/M experience is not required for this role. Essential Duties and Responsibilities (this list does not include all duties assigned) Performs coding services while meeting daily production and quality goals Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards. Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services. Collaborate with healthcare providers to clarify diagnoses and procedures to...

## Clinical Documentation Improvement Nurse Coder (Certified)Applylocations: Portland, MEtime type: Full timeposted on: Posted 2 Days Agojob requisition id: REQ-2026-227Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.## Position SummaryThe Clinical Documentation Improvement (CDI) Nurse Coder supports accurate and complete clinical documentation that reflects the severity of illness, quality...

Coding Auditor Senior Candidates must reside either in Washington or Oregon to be considered for this position. Essential Responsibilities: Proficient in medical record review and translating clinical information into coded data. Identify and assign appropriate codes for diagnoses, procedures and other services rendered, while also validating any Computer Assisted Coded (CAC) assignments for dual coding. Utilizing the Code Base Charge Trigger system (CBCT) and OPTUM 360 EncoderPRO software system for professional surgical services, analyzing and maintaining systems accuracy, validity and meaningfulness for both professional and facility services. Utilizes electronic patient data system and clinical information system (EpicCare) to access patient encounter information. Abstracts and enters clinical data elements as defined by the needs of the organization. Identifies and assigns principal diagnosis and procedure codes, sequencing them as needed for proper Ambulatory Payment...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Submits daily productivity report to HIM...

Coding Specialist Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Submits daily productivity...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Job Overview The Coder, Risk Adjustment position provides a thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient. The Risk Adjustment Coder is responsible for evaluating the accuracy and...

AltaMed Health Services Corp. is seeking a Risk Adjustment Coder in Montebello, CA to review ambulatory records for accurate capture of illness severity and case complexity. The role emphasizes concurrent, prospective, and retrospective coding reviews in compliance with applicable guidelines. The candidate should have at least 2 years of risk adjustment coding/audit experience, proficiency with multiple EHR/EMR systems, and hold CRC, CPC, or CCS/CCS-P certifications (CRC preferred). #J-18808-Ljbffr

AltaMed Health Services Corporation in Montebello, CA is hiring a Risk Adjustment Coder to conduct concurrent, prospective and retrospective reviews of ambulatory records to ensure accurate capture of illness severity and complexity. Requires a High School Diploma and at least 2 years in risk adjustment coding or auditing, plus EHR/EMR experience. Certifications such as CRC/CPC/CCS/CCS-P are preferred; CRC must be obtained within the first year. #J-18808-Ljbffr

Are you an experienced outpatient coder ready for something more? We’re looking for an OutpatientCDS/Coder to join our Valleywise Health CDI team. This is a unique hybrid role designed for an experienced outpatient coder who wants to expand their skills into Clinical Documentation Integrity while continuing to perform production coding . You’ll build on your coding expertise through clinical documentation review, compliant query generation, provider education, risk adjustment, and documentation improvementwhile still coding and staying connected to the work you know. Strong outpatient coding experience is the foundation. We’ll help you grow the CDI side. Valleywise Health is committed to providing high-quality, comprehensive benefits designed to help our employees and their families stay physically and financially fit. Known for the diversity of not only the community of patients we serve but also our workforce and the benefits we offer, such as: Medical, Dental, and...

Location Location:Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Codes various OP service lines for all MHS specialties that include encounters with high complexity of surgical...

HCC Coding Quality EducatorLocation: Madisonville, Louisiana, United States of AmericaCategory: ClericalRemote: Office/Remote HybridScheduled Weekly Hours: 40JOB SUMMARY:The HCC Coding Quality Educator (HC) facilitates the improved integrity of medical record documentation through interaction with healthcare providers to support the appropriate representation of severity of illness, risk of mortality, acuity, and complexity of care. In addition, this position, through a multidisciplinary team approach, performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure an accurate depiction of the true complexity of the patient to support the facilities Risk Adjustment strategy. The HCQE utilizes their coding knowledge, and demonstrates an understanding of current CMS coding guidelines, the impact of procedures and compliant documentation to support the capture of Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity, and medical...

Location Miramar, Florida Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. For physician billing, collaborates with billing department to ensure all bills are satisfied. For hospital, routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections, when advised, and follows procedure to notify billing. Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields following HIM coding...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities: Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Codes various OP service lines for all MHS specialties that include encounters with high complexity of surgical procedures and...

AltaMed Health Services Corp.If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed – it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.Job OverviewThe Coder, Risk Adjustment position provides a thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient. The Risk Adjustment Coder is responsible for evaluating the...

Inpatient Facility Medical Coder (40h Day) Remote Clackamas, OR Candidates must reside either in Washington or Oregon to be considered for this position. To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative...

Company Description Job Description To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional...

Job Description At NorthBay Health the Professional Fee Coding Auditor is responsible for auditing professional fee coding across all service lines (Ambulatory/Hospitalist, Surgery, and Emergency Medicine), resolving pre‑billing coding edits, and reviewing post‑billing coding‑related denials. This role ensures coding accuracy, documentation integrity, and compliance with CPT, HCPCS, ICD‑10‑CM, and payer‑specific rules. The position supports coding quality improvement, identifies trends, provides coder feedback and physician education based on audit and edit findings, and partners with leadership to strengthen coding workflows across the organization. Primary Job Duties Audit Responsibilities Performs routine and targeted professional fee coding audits across all service lines: Ambulatory/Hospitalist (including Urgent Care and Pools), Surgery, and ED ProFee. Reviews documentation for completeness, accuracy, and compliance with CPT, HCPCS, ICD‑10‑CM, and payer policies....

Risk Adjustment Coder Location: Montebello, CA 90640 Job Overview The Coder, Risk Adjustment position provides a thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient. The Risk Adjustment Coder is responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports following all applicable federal, state, and county regulations/laws related to coding, auditing, and clinical documentation guidelines for the various risk adjustment models. May participate in developing, presenting, and disseminating provider communication and other activities related to clinical documentation. Minimum Requirements High School Diploma required. A minimum of 2 years of risk adjustment coding and/or auditing experience is required. Electronic health record (EHR)/medical records (EMR) experience...

AltaMed Health Services Corp. in Montebello, CA seeks a Risk Adjustment Coder to conduct concurrent, prospective, and retrospective reviews of ambulatory records to ensure accurate coding of diagnosis, severity, and complexity. You will validate data quality, support audits, and align documentation with Medicare/Medicaid guidelines. The ideal candidate has 2+ years in risk adjustment coding or auditing, EHR/EMR navigation skills, and certifications such as CRC, CPC, or CCS/CCS-P. #J-18808-Ljbffr

AltaMed Health Services Corp. in Montebello, CA is seeking a Risk Adjustment Coder to perform concurrent, prospective, and retrospective reviews of ambulatory medical records to ensure accurate and complete capture of illness severity and patient complexity. The role requires a High School Diploma and at least 2 years of risk adjustment coding or auditing, with EHR/EMR experience. Candidates should hold CRC, CPC, or CCS/CCS-P, or commit to certification within the first year. #J-18808-Ljbffr

AltaMed Health Services is seeking a Risk Adjustment Coder in a hybrid role based near Montebello, CA. The coder will review ambulatory records to ensure accurate capture of severity of illness and patient complexity, aligning with Medicare Advantage and other risk models. Ideal candidates have at least 2 years in risk adjustment coding/auditing, EHR/EMR proficiency, and certification such as CRC, CPC, or CCS/CCS-P. A competitive hourly pay range is offered with potential bonuses. #J-18808-Ljbffr