10 certified risk adjustment coder jobs found in Washington, DC

Intermountain Health in Las Vegas, NV is seeking an entry-level Risk Adjustment Analyst to learn and apply coding practices for CMS/HHS regulated programs and to audit post-visit clinical documentation for accurate risk adjustment coding. You will support senior analysts, maintain HIPAA compliance, document chart reviews, and work with EMR and MS Office in a 40-hour work week. The position offers an hourly pay range of $28.06–$44.20 and requires CRC certification within 1 year of hire. #J-18808-Ljbffr

Job Description Job Description Description: About the Company: NextStep Technology Inc. is seeking a Medical Records Analyst. The medical records analyst is primarily responsible for review of health information. The MRA reviews the medical records for specific criteria and validation of specific code year sets submitted from selected organizations to government and commercial client. The position requires review of protected health information and must maintain strict confidentiality when addressing or referring to such records. The incumbent must have the ability to use a variety of office equipment, computer software, the ability to use sound and professional judgement, and to work independently. The candidate(s) will be hired as an employee up to 40 hours per week (flexible scheduling). This is a remote position About the Role: The medical records analyst is primarily responsible for review of health information. Responsibilities: Analyze protected...

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire. The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms. Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package. #J-18808-Ljbffr

CareFirst BlueCross BlueShield is looking for a Risk Adjustment Coding Specialist in Baltimore, Maryland. This role involves reviewing and coding medical records, ensuring compliance with federal and state guidelines. You will also develop coding guidelines and provide guidance to junior specialists. The position supports a hybrid working model and offers a salary range between $51,984 and $95,304. The ideal candidate will have an Associate degree in Health Information Technology and at least 3 years of coding experience. Required certifications include CCS or CPC upon hire. #J-18808-Ljbffr

GBMC Health Partners is seeking a Clinical Documentation Improvement Nurse/Nurse Coder to join our Primary Care team. The ideal candidate is a clinically experienced nurse coder who is EMR savvy, knowledgeable in HCC and ICD-10 coding, with exposure to ambulatory medicine. Responsibilities include chart review, identifying documentation improvement opportunities, and educating practice physicians on documentation and coding changes. EPIC experience preferred. #J-18808-Ljbffr

*Description* Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy,...

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD‑9‑CM/ICD‑10‑CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance efforts....

Position Overview The Senior Medical Coding Specialist acts as an internal expert to ensure that value‑based reimbursement and medical policy models are developed and implemented to support Payment Integrity. This role provides expert knowledge to support effective partnership with provider entities, guidance on the appropriate quality‑measure capture and proper use of CPT and ICD‑10 codes in claims submissions. The specialist utilizes coding expertise, combined with medical policy, credentialing and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. This role also provides expertise and mentoring to other team members and will sit within the Payment Integrity team. Essential Functions Consult on proper coding rules in value‑based contracts to ensure appropriate quality‑measure capture and proper use of...

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. Job Overview We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality...

RELI Group, Inc. is seeking an experienced Senior Medical Coder in Baltimore, MD. You will support Medicare Part C Risk Adjustment Data Validation initiatives, performing diagnosis coding across various care settings. The ideal candidate will have a minimum of five years of coding experience and be a certified coder. The role offers an annual salary range of $60,000 to $80,000 based on skills and experience. Join a team that values expertise and impact. #J-18808-Ljbffr