22 crc certified risk adjustment coder jobs found in Hialeah, FL

Position Responsibilities Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs (hierarchical condition categories) Reviews medical record to ensure all diagnosis codes are documented for the assignment of a valid and accurate HCC for each episode of care Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports Queries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment coding Demonstrates understanding of risk adjustment payment models Uses clinical reasoning and critical thinking skills to discern the financial impact of a query in order to prioritize efforts most efficiently Completes patient medical chart review within 24-48 hours of visit completion Responsible for maintaining active status of coding credentials and completes annual continued education hours. Observes work hours and provides proper notice...

Position ResponsibilitiesDemonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs (hierarchical condition categories)Reviews medical record to ensure all diagnosis codes are documented for the assignment of a valid and accurate HCC for each episode of careRegularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reportsQueries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment codingDemonstrates understanding of risk adjustment payment modelsUses clinical reasoning and critical thinking skills to discern the financial impact of a query in order to prioritize efforts most efficientlyCompletes patient medical chart review within 24-48 hours of visit completionResponsible for maintaining active status of coding credentials and completes annual continued education hours.Observes work hours and provides proper notice regarding absences...

As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital...

Cano Health is seeking a Risk Adjustment Coder III to assign ICD-10-CM diagnoses from clinical records in line with established risk adjustment models. You will perform high-volume coding and chart reviews, ensuring data accuracy and regulatory compliance. The role requires CPC/CCS certification, 5 years of coding experience with risk adjustment, and proficiency with ICD-10-CM guidelines. Collaboration with clinical teams and ongoing education are essential. #J-18808-Ljbffr

Job Summary The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit. Duties & Responsibilities Essential Duties & Responsibilities Medical Coding and Documentation Assign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in accordance with established coding guidelines. Perform detailed chart reviews to ensure accurate capture of diagnoses, including HCC codes, following risk adjustment requirements. Identify and correct coding discrepancies based on documented evidence...

Risk Adjustment Coder IIIIt's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.Duties & ResponsibilitiesEssential Duties & ResponsibilitiesMedical Coding and DocumentationAssign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in accordance with established...

Medical Coder I At ClareMedica, exceptional is the standard. Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we're working together to help seniors live happier, healthier, fuller lives. That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees' growth and wellness and where their full potential and value are realized. At ClareMedica, we're excited about great people like you. We're even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities. Opportunity awaits – welcome to ClareMedica. We are seeking an accurate, detailed oriented Coder to join our team. You will play a key role in reviewing...

Cano Health is seeking a Risk Adjustment Coder III to assign ICD-10-CM diagnoses from clinical records in line with established risk adjustment models. You will perform high-volume coding and chart reviews, ensuring data accuracy and regulatory compliance. The role requires CPC/CCS certification, 5 years of coding experience with risk adjustment, and proficiency with ICD-10-CM guidelines. Collaboration with clinical teams and ongoing education are essential. #J-18808-Ljbffr

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. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified...

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...

Risk Adjustment CoderPorter 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 OverviewWe are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home...

Porter is looking for a certified Risk Adjustment Coder to join our team in Pompano Beach, FL. This role is crucial for ensuring the accuracy of coding related to in-home health assessments, requiring strong expertise in risk adjustment coding, as well as the ability to handle multiple clients' specific needs. The ideal candidate will maintain a minimum coding accuracy of 98%, ensuring compliance with CMS guidelines while collaborating with clinical teams to provide insights on documentation improvements. Working hours are Monday to Friday with potential for some weekends and overtime. Join Porter to make a meaningful impact on healthcare delivery! #J-18808-Ljbffr

Porter Cares, Inc. is hiring a Risk Adjustment Coder to improve coding accuracy and facilitate effective in-home health assessments. The ideal candidate will possess a CPC or CSS certification and have a minimum of 5 years of risk adjustment coding experience. Responsibilities include coding assignments, managing documentation accuracy, and supporting coding education initiatives. The position offers a competitive wage between $50,000 - $54,000 annually with opportunities for professional growth. #J-18808-Ljbffr

Porter is hiring a Risk Adjustment Coder to support in-home health assessments. The ideal candidate will have a CPC or CSS certification and at least 5 years of risk adjustment coding experience, ensuring 98% coding accuracy and compliance with CMS guidelines. Responsibilities include coding documentation, managing provider queries, and providing feedback for improved coding practices. This position is based in Pompano Beach, FL and includes competitive benefits and opportunities for professional growth. #J-18808-Ljbffr

Risk Adjustment Nurse/Coder AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA) in Doral, FL! Status: Full-time permanent position (40 hours) Standard working hours: 8am to 4:30pm EST, M-F Location: This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary The Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical...

ClareMedica Health Partners is seeking an accurate, detail-oriented Medical Coder to review records and assign codes for risk-adjustment models and office procedures. You will evaluate charts, validate coding accuracy, and ensure compliance with coding guidelines. The ideal candidate holds CPC or CRC certification, with 2+ years of coding experience, strong terminology knowledge, and proficiency in EMR software and MS Office. #J-18808-Ljbffr

Health Information Management (HIM) Coding SpecialistLocation: Miramar, FloridaAt 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.SummaryReviews 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.ResponsibilitiesEnhances 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. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical...

Job TitleLocation: Miramar, FloridaAt 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.Job DescriptionReviews 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.ResponsibilitiesCommunicates 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.Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing).May assign and sequence basic CPT (Current Procedural...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Schedule: Monday-Friday, 8-hour shifts between the hours of 7am-5pm PST. Training schedule will be 8:30am-5pm PST. Schedule to be determined by supervisor upon hire. Location: 2716 North Tenaya Way, Las Vegas, NV 89128. Travel will be required up to 50% of the time for chart retrievals. The Medical Coder supports IPA (Independent Provider Association) Providers with ongoing ICD-10 CM Coding Education...

AvMed, a division of Sentara Health Plans, seeks a Risk Adjustment Nurse/Coder (RN/CPC/COC/CIC/CCS-P/CCS/RHIT/RHIA) to join the hybrid Doral, FL team. The role focuses on risk adjustment coding and CMS/HHS guidelines, with activity spanning medical record reviews and RADV audits. Qualifications include an associate degree and relevant certifications, plus 2 years of coding experience or 4 years without a degree. Competitive benefits offered, with a base salary range disclosed. #J-18808-Ljbffr

Risk Adjustment Coder 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...

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...