285 hcc risk professional coder jobs found

CURRENT BRONSON EMPLOYEES - Love Where You Work! Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community. If you’re ready for a rewarding new career, join Team Bronson and be part of the experience. Location BHG Bronson Healthcare Group Title HCC Risk Professional Coder Full-Time (80 hours per pay period) The Professional Coder performs detailed review of provider documentation/dictation and performs research on code selection for validation of appropriate codes selected for surgically complex cases (e.g., Neurosurgery, Cardiothoracic Surgery). Provides codes for surgical cases for insurance authorization. Reviews work queues and/or posts charges into Practice Management System for provider hospital and office billing and complex surgical cases (e.g. Neurosurgery, Cardiothoracic Surgery). Employees providing direct patient care must...

Love Where You Work!Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community.If you’re ready for a rewarding new career, join Team Bronson and be part of the experience.LocationBHG Bronson Healthcare GroupTitleHCC Risk Professional Coder Full-Time (80 hours per pay period)The Professional Coder performs detailed review of provider documentation/dictation and performs research on code selection for validation of appropriate codes selected for surgically complex cases (e.g., Neurosurgery, Cardiothoracic Surgery). Provides codes for surgical cases for insurance authorization. Reviews work queues and/or posts charges into Practice Management System for provider hospital and office billing and complex surgical cases (e.g. Neurosurgery, Cardiothoracic Surgery). Employees providing direct patient care must demonstrate competencies specific to the...

Love Where You Work!Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community.If you’re ready for a rewarding new career, join Team Bronson and be part of the experience.LocationBHG Bronson Healthcare GroupTitleHCC Risk Professional Coder Full-Time (80 hours per pay period)The Professional Coder performs detailed review of provider documentation/dictation and performs research on code selection for validation of appropriate codes selected for surgically complex cases (e.g., Neurosurgery, Cardiothoracic Surgery). Provides codes for surgical cases for insurance authorization. Reviews work queues and/or posts charges into Practice Management System for provider hospital and office billing and complex surgical cases (e.g. Neurosurgery, Cardiothoracic Surgery). Employees providing direct patient care must demonstrate competencies specific to the...

Bronson Healthcare Group is seeking a HCC Risk Professional Coder for full-time work in Kalamazoo. The role involves detailed review of provider documentation, code validation for complex surgical cases, and posting charges in the Practice Management System for hospital and office billing. Candidates should have a high school diploma or GED, 12–18 months of coding experience, and must obtain a certified coding credential within 12 months of hire. #J-18808-Ljbffr

Certified Professional Coder (CPC) Lead/Provider LiaisonA Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.This is Contract position with my direct clientJob DescriptionDirect Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be: Newark, NJ OR West Trenton OR Ewing OR Wall, NJDuration: Contract to HireJob Summary:The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for...

HCC Coding Quality EducatorLocation: Madisonville, Louisiana, United States of AmericaCategory: ClericalRemote: Office/Remote HybridScheduled Weekly Hours: 40JOB SUMMARY:The HCC Coding Quality Educator (HC) facilitates the improved integrity of medical record documentation through interaction with healthcare providers to support the appropriate representation of severity of illness, risk of mortality, acuity, and complexity of care. In addition, this position, through a multidisciplinary team approach, performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure an accurate depiction of the true complexity of the patient to support the facilities Risk Adjustment strategy. The HCQE utilizes their coding knowledge, and demonstrates an understanding of current CMS coding guidelines, the impact of procedures and compliant documentation to support the capture of Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity, and medical...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation...

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 Coder of Risk Adjustment will be responsible...

Risk Adjustment Coder Location: Baton Rouge, LA 70809 Contract Length: 4 Months Position Summary We are seeking an experienced Risk Adjustment Coder with a strong background in Medicare Advantage Risk Adjustment and ACA Risk Adjustment coding. This position supports ongoing risk adjustment initiatives through accurate coding, medical record review, documentation validation, and quality assurance activities. The coder will help ensure compliance with CMS and other regulatory requirements while supporting risk adjustment accuracy and revenue integrity goals. Candidates should have demonstrated experience with CMS-HCC coding methodologies, medical record review, and risk adjustment documentation validation . This position works under general supervision and does not have direct supervisory responsibilities. Key Responsibilities Review and assess medical record documentation and accurately assign ICD-10-CM diagnosis codes for Medicare Advantage and ACA...

Job Summary The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. Job Summary The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. Key Responsibilities Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements. Ensure documentation...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation...

Medical Coding Professional 2The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies.The...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for an outpatient Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payors. Researching...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!Hours: Monday - Friday, dayshift.This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week or must be able to do site visits. The role also includes travel as needed to support business objectives and team collaboration.OverviewPerforms 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 Condition Categories...

Astrana Health in Orange County seeks a Risk Adjustment Coding Specialist to support high-volume chart reviews and identify coding gaps for Medicare Advantage, ACA, and Commercial plans. You will translate findings into provider education, deliver insights, and track KPIs like HCC recapture rates and AWVs while traveling to provider offices as needed. This role supports a hybrid work model with on-site and field responsibilities. #J-18808-Ljbffr

Job Title:Quality Assurance Auditor/Coder Location: Phoenix, AZ or Remote Duration: 06 Month+ Conract Pay Range: $45/Hour on w2 Summary We are seeking an experienced Quality Assurance Auditor with coding background. strong background in HCC coding, risk adjustment, and medical record auditing . The ideal candidate will have experience reviewing medical records, conducting QA audits, identifying coding deficiencies, and supporting provider education and risk mitigation initiatives. Required 5+ years of professional coding experience, 3+ years of HCC/risk adjustment experience, 2+ years of auditing/QA experience, and an active CCS-P, CRC, CPC, or COC certification . Experience Experience with Medicare Advantage, RADV, HEDIS, CMS Star Ratings, and provider education is strongly preferred. #J-18808-Ljbffr

HCC Medical Coder Location: Fully Remote Positions Available: Up to 200 Employment Type: Contract (2 months) Pay Rate: $27/hour Schedule: Full-time preferred Minimum 20 hours/week between 8:00 AM – 8:00 PM CST Must be available 8:00 AM – 5:00 PM CST for the first 2 weeks of training Training: 2 weeks, Monday–Friday Contract End Date: January 31, 2026 Equipment: Provided Paid Time Off: Not included; paid only for hours worked Job Summary We are seeking experienced HCC Medical Coders to join a large-scale remote project. In this role, you will review medical charts, assign accurate ICD-10 codes for risk adjustment, and ensure compliance with coding standards. Successful candidates will demonstrate strong attention to detail, coding accuracy, and productivity while working independently in a fast-paced environment. Key Responsibilities Assign accurate ICD-10 codes for physician and facility services in observation and inpatient settings Maintain knowledge of...

Edward Elmhurst Health in Skokie, IL is seeking an Ambulatory Risk Adjustment Coding Specialist to identify HCC codes in physician outpatient visits and ensure they are coded with highest specificity. You will verify that documentation meets CMS requirements and work with ambulatory CDS to confirm code accuracy. Responsibilities include abstracting HCCs, identifying chart-level impairments, partnering with physicians to improve documentation, onboarding new staff, keeping ICD-10-CM knowledge #J-18808-Ljbffr

Arizona Priority Care in Chandler, AZ seeks a Coder II to identify and report HCC diagnoses from chart reviews across outpatient and inpatient settings. The role emphasizes accurate ICD-10 coding, CMS STAR support, and collaboration within a team. The candidate should hold AHIMA/AAPC certification with 2 years HCC coding experience, and be comfortable with Excel/Word. A 60-day in-office presence is required; hybrid options may follow. #J-18808-Ljbffr