236 certified risk adjustment coder jobs found

A company is looking for a Remote Retro-Retrieval Coder. Key Responsibilities Perform code abstraction of medical records to ensure accurate ICD-10-CM code assignment Identify diagnosis and chart level impairments and opportunities for documentation improvement Maintain knowledge of coding guidelines, regulations, and assist in process improvements Required Qualifications Minimum of 3 years certified with a core coding credential from AHIMA or AAPC (CRC, CPC, CCS, CCS-P) At least 1 year of recent production coding experience in Retrospective Risk Adjustment coding 1+ years of experience working with Medicaid plans Required code set knowledge and coding experience in Medicaid, Medicare, and Commercial benefit plans Minimum of 1 year coding experience with Complete Code Capture

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Senior Director, Health Care Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a...

Ankura is a team of excellence founded on innovation and growth.**Practice Overview:**Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Hybrid | Des Moines, IA (Onsite Tues–Thurs, Remote Mon/Fri) $40/hour | 6-Month Contract with Potential for Conversion We are seeking a Certified Risk Adjustment Coder (CRC) to support Medicare Risk Adjustment initiatives through detailed HCC medical record reviews and direct provider engagement. This role is ideal for someone confident, collaborative, and comfortable working onsite with provider teams to drive documentation accuracy and performance improvement. This position requires onsite presence Tuesday–Thursday in Des Moines, IA with 10% local travel , and remote flexibility on Mondays and Fridays. Position Overview This role performs concurrent medical record reviews to ensure accurate capture of HCC conditions and appropriate documentation reflecting patient severity of illness. The coder will collaborate closely with physicians, clinical leadership, and provider engagement teams to improve documentation practices and support compliance with CMS guidelines. Key...

Job DescriptionJob DescriptionSUMMARYThe Certified Risk Adjustment Coder is responsible for accurately abstracting provider services into ICD-10 codes from medical documentation.This role adheres to the coding ethics of organizations such as the American Academy of Procedural Coders (AAPC), American Health Information Management Association (AHIMA), and the National Alliance of Medical Auditing Specialists (NAMAS), as well as payer guidelines.The coder conducts concurrent, prospective, and retrospective reviews of medical record documentation to ensure the accurate and complete capture of the clinical picture, severity of illness, and complexity of patients.Additional duties include provider communication and education to support the closure of both risk adjustment and quality care gaps, as well as providing ongoing feedback to physicians regarding coding guidelines and requirements.ESSENTIAL JOB FUNCTIONSPerform coding quality audits of medical records to ensure ICD-10 codes are...

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment coding and...

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

Centauri Health Solutions, Inc. is seeking a Risk Adjustment Coder based in Tempe, Arizona. In this role, you will perform medical record coding and ensure accuracy per ICD-10-CM standards. The position requires a minimum of three years of coding experience along with AHIMA or AAPC certification. Benefits include comprehensive health coverage and a 401(k) plan. Ideal candidates must have experience with Medicaid coding as well as strong communication skills and a technical savvy in computer applications. #J-18808-Ljbffr

Job Type Full-time Description 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...

A healthcare company in Houston is seeking a Certified Medical Coder to review and code inpatient and outpatient medical records. You will ensure compliance with ICD-10-CM and HCPCS guidelines while meeting productivity standards. Candidates need a high school diploma, relevant certifications, and at least three years of experience in risk adjustment. AAPC or AHIMA credential is required. The role also values attention to detail and knowledge in managed care. #J-18808-Ljbffr

Hcc Coder Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered. Travel to provider office location/offices for HCC education as determined by manager Mandatory on-site team meetings in Midland 1 x per month To be part of our organization, every employee should understand and share in the MyMichigan Health Vision, support our Mission, and live our Values. These values include excellence, integrity, teamwork, and accountability – must guide what we do, as individuals and professionals. The HCC Coder, working under the direction of the Clinical Documentation Integrity Manager, utilizes coding expertise to identify areas of opportunity that impacts the quality and the completeness of the medical record documentation. Through prospective, concurrent, and retrospective evaluation of the medical record documentation, the HCC Coder will be responsible for working collaboratively with the clinical team members...

American Health Partners in Franklin, TN seeks a Medicare Risk Adjustment Coding Specialist to conduct coding audits and reviews. The role involves ensuring coding accuracy for Medicare claims and providing educational correspondence to providers. Candidates should have experience in the health insurance industry, excellent communication skills, and relevant coding certifications. This position offers a collaborative work environment with various employee benefits including health insurance and a paid time-off program. #J-18808-Ljbffr

EDUCATION & EXPERIENCE: Minimum Qualifications: Three years of multi-specialty coding experience. Proficient in coding Professional services, and/or Outpatient professional and hospital technical services. Experience with communicating, training, and educating providers in proficiency. Preferred Qualifications: Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations. Experience in OB and Women's Specialties in an outpatient or clinic setting. REQUIRED LICENSES, REGISTRATIONS, OR CERTIFICATIONS: One of the following: CCA – Certified Coding Associate (AHIMA) or CCS – Certified Coding Specialist (AHIMA) or CCS-P – Certified Coding Specialist – Physician Based (AHIMA) or RHIA – Registered Health Information Administrator (AHIMA) or RHIT – Registered Health Information Technician (AHIMA) CIC – Certified Inpatient Coder (AAPC) or COC – Certified Outpatient Coder...

A company is looking for a Remote PRN HCC Coder with CRC. Key Responsibilities Codes inpatient and outpatient medical records using ICD-9/10 CM and CPT-4 classification systems Abstracts data for quality improvement and compliance with regulations Resolves pre-bill edits and maintains up-to-date knowledge of coding regulations Required Qualifications High school diploma or GED required Certification in coding (HCS-D, CCS, CCS-P, CPC-H, CPC, or RHIT/RHIA) required at hire One to three years of coding experience required Computer skills in Word, Excel, and PowerPoint required Experience with an encoder and Electronic Medical Records preferred

A company is looking for a Risk Adjustment Coder to join their team. Key Responsibilities Review and abstract diagnosis information from medical records according to coding guidelines Assign appropriate ICD-10-CM codes based on provider documentation Ensure coding accuracy and completeness for risk adjustment purposes Required Qualifications, Training, and Education CPC-A certification preferred (Certified Professional Coder - Apprentice from AAPC) Strong knowledge of anatomy and physiology Familiarity with EHR systems and medical record platforms Understanding of Medicare and/or Medicaid coding guidelines Ability to work in a fast-paced, deadline-driven environment

A company is looking for a Coder 1/HCC Risk Adjustment. Key Responsibilities Conducts accurate diagnosis code abstraction for Medicare, Commercial, and Medicaid risk adjustment programs Stays updated on coding guidelines through required trainings and personal research Communicates findings and suggestions to Team Lead to improve department operations Required Qualifications Minimum High School Diploma Nationally certified coder in good standing through AAPC or AHIMA (e.g., CRC, CPC, CCS) 1-2 years of experience in medical risk adjustment/HCC coding Strong knowledge of medical terminology and anatomy Intermediate computer skills for coding processes