5 crc certified risk adjustment coder jobs found in Los Angeles, CA

Job Description Job Description Education and/or Experience :   Must have these requirements under the umbrella of the HCC industry: Requires knowledge in HCC Coding documentation guidelines. Requires technical expertise in ICD-9-CM or ICD-10-CM. Strong skills in medical record audit and review. Regulatory requirements for coded data. Medical record documentation requirements. Understanding of healthcare data systems. Proficiency in MS Outlook and Word. Strong proficiency with Excel--must have ability to prepare spreadsheets. Excellent written and verbal communication skills. Certification is a plus with HCC. AHA coding clinic is a plus. Certification required in CPC and/or CCS, and CRC is a plus. Hybrid Schedule Requirements Part A Monday - Wednesday onsite / Thursday - Friday Remote Part B Wednesday - Friday Onsite / Monday - Tuesday Remote   We are looking for HCC Risk Adjustment Auditors/Coders to join our team!   Position...

Job Description Job Description THE ROLE As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients and their families and government agencies, and AMM is committed to exceeding those expectations. The Program is led by AMM’s CCEO, who reports to AMM’s Chief Executive Officer and the AMM Board, and who oversees and manages the AMM Compliance Committee, consistent with industry best practices. The Compliance Coding Auditor for the Auditing, Tracking, and Monitoring team is expected to exemplify the Company’s culture and core values. This is a role that requires sound and risk-aware judgment, productive collaboration across the...

Join to apply for the Compliance Coding Auditor , ATM role at Advanced Medical Management, Inc. Your actual pay will be based on your skills and experience. Talk with your recruiter to learn more. Base pay range: $75,000 to $80,000 per year. Role Overview As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important driver of our mission. They are responsible for supporting the Company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients, families, and government agencies. The Program is led by AMM’s Chief Compliance & Ethics Officer, who reports to the CEO and the Board, and oversees the AMM Compliance Committee. This role requires sound, risk‑aware judgment, productive collaboration across the Company, and demonstrated success in performing audits to...

Description Support compliance excellence at UCLA Health by joining our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager, MAPD Audit, you will contribute to the organization's audit work plan, assess operational risk areas, and prepare audit findings that help guide regulatory readiness and operational improvement. This position calls for a strong foundation in CMS guidelines, managed care compliance, and effective collaboration with both internal teams and external partners. In this role, you will: * Conduct compliance audits related to operational functions, vendor performance, data validation, RADV, Triennial Review, pre-delegation reviews, and...

Job Description Job Description South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding. Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit HEDIS coding and record collection...