42 hcc risk adjustment coder ii jobs found

St Luke's Health is looking for a Value Based Coder II in Houston, Texas. This role involves reviewing patient medical records to enhance coding opportunities with a strong emphasis on Hierarchical Condition Categories (HCC). The ideal candidate will have 2+ years in outpatient coding and a deep understanding of risk adjustment principles. Responsibilities include providing education to network providers and ensuring compliance with coding guidelines. #J-18808-Ljbffr

A leading healthcare provider in Texas is seeking an experienced Value Based Coder II to review medical records for coding opportunities, focusing on Hierarchical Condition Categories (HCC). The role involves developing provider education and ensuring compliance with coding guidelines. Candidates should have a Bachelor's degree in healthcare or equivalent experience, CPC/CCS/CRC certification, and at least 2 years of outpatient coding experience. Competitive hourly pay ranges from $25.30 to $35.74. #J-18808-Ljbffr

Direct Jobs is seeking a Risk Adjustment Coder II in Houston, Texas. This role involves advanced support for medical record reviews, ensuring correct capture of chronic conditions and compliance with CMS guidelines. The Coder II acts as a subject matter expert, facilitating team training and audits. The ideal candidate will have a Bachelor's degree or equivalent experience in risk adjustment, along with relevant coding certifications. Experience in Commercial and Medicare coding is required alongside strong analytical and communication skills. #J-18808-Ljbffr

340B Health is seeking a Risk Adjustment Coder II to provide advanced support for medical record reviews and ensure accurate capture of chronic conditions. This role involves coding according to CMS guidelines and improving documentation standards. The ideal candidate will have a Bachelor's Degree or equivalent experience and be an AHIMA/AAPC Certified Coder with 3-5 years of relevant coding experience. Strong analytical and interpersonal skills are essential. This position supports Medicare and Commercial Risk Adjustment programs. #J-18808-Ljbffr

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II for Orange County. This role focuses on chart reviews to identify coding gaps and drive accuracy for Medicare Advantage, ACA, and commercial plans. You will educate providers, track KPIs like HCC recapture and AWVs, and work up to 75% travel to provider offices in Orange County. AAPC/AHIMA certification and 3+ years of risk adjustment experience are preferred. #J-18808-Ljbffr

Job Summary The RN Field Coder will be responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. The RN Field Coder will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work supported by the RN Field coder will include pre, post and wraparound visit input. Pre-Visit: Reviewing the medical records, outside results and health plan data for upcoming patient appointments and flagging important insights for the provider to review before seeing the patient. Post Visit: Reviewing the provider note, populating all supported codes (ICD-10, CPT, CPT-II, etc.), and assisting submission of encounter for claim processing. Wrap Around Education: Periodic review of findings, highlighting areas of opportunity in documentation and ongoing education. Provider querying and education...

At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $26.00/hr - $27.00/hr Direct message the job poster from Insight Global Professional Recruiter at Insight Global We are looking for a full-time REMOTE HCC/Risk Adjustment Medical Coder for a contract up to 12 months with possible extensions or conversions. Must hold an active CPC or CCS, as well as 3+ years of HCC/risk adjustment coding experience. ****The pay rate is $25-26.50 per hour depending on experience**** Job Summary: Insight Global is hiring HCC/Risk Adjustment Medical coders to support a backlog for inpatient and outpatient Medicare Advantage projects. Candidates must obtain an active Coding certification (CPC) through AAPC or AHIMA. The role primarily involves risk adjustment coding, focusing on HCC ICD-10 codes. Experience with problem list coding is a plus but not required. Responsibilities include validating...

4 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Colorado Community Managed Care Network provided pay range This range is provided by Colorado Community Managed Care Network. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $53,000.00/yr - $70,000.00/yr Direct message the job poster from Colorado Community Managed Care Network Director of Human Resources and Business Operations Description https://recruiting.paylocity.com/recruiting/jobs/All/3736f22c-4667-493c-828e-5131b681ff09/Colorado-Community-Managed-Care-Network. Applicants will must apply through this link to be considered. Responsibilities: The Value Based Coding Advisor will interact with operational and clinical leadership to assist in the identification of Risk Adjustment/HCC coding opportunities, and will provide targeted education to CHC providers, billers, coders, and support staff to support...

How You’ll Make An Impact At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel right at home at Strive! Benefits & Perks Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support –...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. Advanced...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk‑adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. Advanced...

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary The RN Field Coder will be responsible for documentation and coding review of...

Work Schedule: This is a full-time, 1.0 FTE position that is 100% remote. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states. Approved Remote Work States Listing Be part of something remarkable Join the #1 hospital in Wisconsin! We are seeking a Medical Coding Specialist II to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD)...

Value Based Coder II Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate...

RN Field Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The RN Field Coder will be responsible for documentation and coding review of medical records where...

RN Field Coder The RN Field Coder will be responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. The RN Field Coder will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work supported by the RN Field coder will include pre, post and wraparound visit input. Pre-Visit: Reviewing the medical records, outside results and health plan data for upcoming patient appointments and flagging important insights for the provider to review before seeing the patient. Post Visit: review the provider note, populate all supported codes (ICD-10, CPT, CPT-II, etc.), and assist submission of encounter for claim processing. Wrap Around Education- periodic review of findings, highlighting areas of opportunity in documentation and ongoing education. The Field Coder will be responsible for...

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The RN Field Coder will be responsible for...

Work Schedule: This is a full-time, 1.0 FTE position that is 100% remote. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states. Approved Remote Work States Listing Be part of something remarkable Join the #1 hospital in Wisconsin! We are seeking a Medical Coding Specialist II - HB Fiscal Coder to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD)...

Job Description Work Schedule: This is a full-time, 1.0 FTE position that is 100% remote. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states. Approved Remote Work States Listing Be part of something remarkable Join the #1 hospital in Wisconsin! We are seeking a Medical Coding Specialist II - HB Fiscal Coder to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage...

Job Summary (List Format) - Outpatient E/M Coder - Assign accurate CPT®, ICD-10-CM, and HCPCS Level II codes for outpatient E/M services based on Medical Decision Making (MDM) and current guidelines. - Apply HCC (Hierarchical Condition Category) coding principles to support risk adjustment and complete clinical documentation. - Review provider documentation for completeness, specificity, and medical necessity; query providers when needed. - Ensure compliance with CMS, AMA, ICD-10-CM guidelines, payer requirements, and internal coding policies. - Meet established coding productivity and quality benchmarks. - Assist with coding audits, provide education feedback, review denials, and support other coding projects as assigned. - Participate in team meetings, training sessions, and after-hours meetings scheduled in Pacific Time. - Maintain patient privacy and confidentiality in accordance with HIPAA and organizational standards. - Stay updated on coding guideline changes,...

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support our physician practices remotely. You will perform high-volume chart reviews to identify coding gaps and improve accuracy, translating findings into education for providers and practice leaders while tracking KPIs such as HCC recapture and AWVs. The ideal candidate has 3–5 years of risk adjustment experience, CPC/CRC credentials, and strong communication skills to educate and collaborate with provider teams. #J-18808-Ljbffr

RN Field Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The RN Field Coder will be responsible for documentation and coding review of medical records where...

Remote Position Submission Requirements AAPC certificate required; MUST be CPC, CPC-H and/or COC Proficiency in AT LEAST 3 of the following: Specialty Clinics (Med Spec Inject, Anticoag Management, Nutrition/Oncology Nutrition, Newborn/Lactation, OP Orthotic Prosth, Urology, Apheresis, Cardiac Rehab, General Surgery, Int Pain Healing, Non Inv Cardiology, Outpatient General Surgery, Proctology, Plastic Surgery, Endocrine, Benign Gyn, Infectious Disease, Neurosurgery, Oral & Facial Surgery, Ortho Total Joint, RAD CT, RAD MRI, Trauma, Amputation Clinic, Burn Clinic, Dermatology, Endocrine Surgery, ENT Clinic, GI and Liver Disease, Gyn Dysplasia, Internal Medicine, Mineral Metabolism, Ortho Foot & Ankle, Pain, Burn Outpatient, Hand Surgery, Cardiology, Comprehensive Wound, Neurology, Pulmonology Clinic, Rheumatology, Eye Clinic, Access Clinic) Must be able to handle HIGH volume of cases Evaluation Management experience required Hospital experience strongly desired...