141 medical coding specialist risk adjustment jobs found

All Jobs > MEDICAL CODING SPECIALIST-RISK ADJUSTMENT MEDICAL CODING SPECIALIST-RISK ADJUSTMENT Fully Remote • Remote N/A • OBS Full-time Description MAKE A DIFFERENCE AT OCHIN OCHIN is a nonprofit leader in health care innovation and a trusted partner to a growing national provider network, delivering the clinical insights and tailored technologies needed to expand patient access, strengthen care teams, and improve the health of rural and medically underserved communities. We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our vision of good health and well-being for everyone. At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture rooted in our values. Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 1,200 skilled professionals, working...

Job Type Full-time Description MAKE A DIFFERENCE AT OCHIN OCHIN is a nonprofit leader in health care innovation and a trusted partner to a growing national provider network, delivering the clinical insights and tailored technologies needed to expand patient access, strengthen care teams, and improve the health of rural and medically underserved communities. We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our vision of good health and well-being for everyone. At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture rooted in our values. Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 1,200 skilled professionals, working remotely across 49 states. We offer a generous compensation package and are committed to supporting our...

A healthcare organization in Florida is seeking a full-time in-house Coding Specialist to enhance its MRA Department. The role involves reviewing medical records, consulting with physicians, and ensuring accurate diagnosis coding in compliance with CMS and ICD-10 guidelines. Ideal candidates should hold CPC, CRC, or CCS certifications, have a minimum of 1-year experience in medical coding, and possess strong knowledge of CMS Risk Adjustment methodology. Excellent communication and computer skills are essential for success in this role. #J-18808-Ljbffr

OCHIN, Inc. is a national nonprofit health care innovator with a growing remote workforce serving member clinics and hospitals. The Medical Coding Specialist - Risk Adjustment role focuses on accurate risk-adjustment coding, high-quality data abstraction, and revenue optimization. Candidates must hold CPC/CCS/ADCA certification (in hand) and have Epic EHR experience if possible. FQHC experience is highly desirable; this is a fully remote, nationwide position with ongoing professional growth #J-18808-Ljbffr

OCHIN, Inc. is seeking a Medical Coding Specialist—Risk Adjustment for a fully remote role. You will perform high-quality outpatient coding with emphasis on risk adjustment, ensuring compliance and accurate reimbursement across a national network. The ideal candidate will have CPC/CCS/CDC certification, experience with Epic EHR, and familiarity with FQHC settings. This position supports a 100% remote workforce and requires working from home with reliable internet access. #J-18808-Ljbffr

OverviewThe Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.Essential DutiesCompletes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewedReviews audit...

Certified Professional Coder (CPC) Lead/Provider Liaison A 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 client Job Description Direct 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, NJ Duration: Contract to Hire Job Summary: The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational...

Provider Liaison - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS) A 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. Job Description One of our direct client is looking for potential candidate with the below mentioned skills Direct Client: Immediate Interview Contract to Hire Position: Provider Liaison MUST HAVE: 5 years of experience into Project Management At least 2 years of experience after CPC or CCS certification Bachelor's degree is a must Certifications AAPC Certified Professional Coder (CPC) or AHIMA...

CW Risk Adjustment Coder Experienced Risk Adjustment Coder with a strong background in Medicare Advantage Risk Adjustment coding 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 the organization's 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 Risk Adjustment programs. Perform retrospective and prospective coding reviews to identify...

Coding Specialist Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the...

CW Risk Adjustment Coder Position Summary Experienced Risk Adjustment Coder with a strong background in Medicare Advantage Risk Adjustment coding 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 the organization's 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 Risk Adjustment programs. Perform retrospective and prospective coding...

Sanford Health is seeking a Coding Audit Specialist to ensure accurate risk adjustment coding across Medicare Advantage, ACA/Exchange and BadgerCare Plus populations. You will audit medical records, apply CPT/ICD-10 guidelines, and present concise audit outcomes to leadership. Ideal candidates have CPC certification within a year, 3 years in health insurance or auditing, and strong knowledge of CMS guidelines, documentation standards, and data analysis. #J-18808-Ljbffr

Specialty Coder At St. Luke's, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke's is truly a great place to work. What You Can Expect: Under limited supervision, Specialty Coder is responsible for reviewing applicable documentation and assigning or validating appropriate procedure and diagnosis codes. Reviews notations, diagnosis, or procedure information in medical record to assign or validate appropriate diagnosis and procedure codes, ensuring accuracy and appropriateness of codes. Applies basic knowledge of coding to solve unique or new cases resulting in the assignment and sequencing of diagnosis and procedure codes. Ensures documentation...

Coding Specialist Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the...

ASAAR Medical is seeking a HCC Coder & Provider Engagement Specialist ** May require travel ** Duties: Reporting to the Director of MRA and Risk Adjustment Coding. The HCC / MRA Coder will offer real-time support and coordination for Primary Care Providers and Care Coordinators for MRA Risk Coding in a value-based care setting. Engages providers by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts ASAAR Medical's overall success first. Review patient charts and pursues excellence: Seeks out learning, strives to develop and expand personally, and continuously helps practices upgrade their capability to contribute to the ACO. Helps to educate clinician and non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk Adjustment (MRA) procedures. Assists in education and transition with onboarding new providers, optimally within their first month. Reviews...

Coding Specialist Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the...

Inpatient Facility Medical Coder (40h Day)RemoteClackamas, ORCandidates must reside either in Washington or Oregon to be considered for this position.To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI);...

POSITION INFORMATION Company: New Horizon Billing Solutions (NHBS) Department: Medical Billing – Revenue Cycle Management (RCM) Location: In-Office / On-Site – Las Vegas, NV Schedule: Monday – Friday, 9:00 AM – 5:00 PM Employment Type: Full-Time Benefits: PTO, Medical, Dental, Vision, 401(k) POSITION SUMMARY The Certified Medical Coder is responsible for reviewing patient medical records and accurately translating diagnoses, procedures, and healthcare services into standardized ICD-10-CM, CPT, and HCPCS codes. This role ensures accurate billing, proper insurance reimbursement, compliance with federal, state, and payer regulations (including LCD/NCD guidelines), and efficiency across revenue cycle operations. The coder collaborates closely with providers, the billing team, and the auditing function to clarify documentation, resolve discrepancies, and support coding audits and reviews. KEY RESPONSIBILITIES Coding & Documentation Review Review medical records and assign...

Risk Adjustment Coding and Documentation Specialist - remote eligible Facility Kootenai Care Network Department Kootenai Care Network Schedule/Shift/Hours Full Time - Days - Remote Eligible This position is US-Remote Eligible. Currently,KootenaiHealth employees cannot be located in: California, Hawaii, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Rhode Island, Vermont, Washington D.C., West Virginia, or Wyoming. This list is continuously evolving and may be updated. Travel to our main campus in Coeur d'Alene, Idaho requiredapproximately 2-4 times annually. Position Summary This position is responsible for facilitating the improvement in the overall quality, completeness, and accuracy of practice-based clinical diagnosis coding and documentation. Responsibilities Verifies and ensures the accuracy, completeness, specificity, and appropriateness of risk adjustable diagnosis codes and...