Medical risk adjustment specialist jobs

Medical Risk Adjustment Specialist (Coder)

Greenbrookmedical Florida, NY, USA

Medical Risk Adjustment Specialist (Coder) Remote Please only submit an application if you live in one of these states: FL, VA, TX, NY, MO About Us At Greenbrook Medical, we believe seniors deserve more from the healthcare system—more time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we’d want for our own parents. Founded by two brothers inspired by their father’s pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they’re never alone in a complex system. Our business model is designed around patient outcomes, not volume—so we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we’re growing thoughtfully to bring our model to more communities. Our team is the heart of it all:...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Tampa, FL, USA

Job Description Job Description Please only submit an application if you live in one of these states: FL, VA, TX, NY, MO About Us At Greenbrook Medical, we believe seniors deserve more from the healthcare system—more time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volume—so we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven,...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Layton, FL, USA

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Toledo, OH, USA

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

Full Time Contract

Position: Mid-Level Manager/Lead Senior Coder

PAC GROUP LLC Remote

Position: Mid-Level Manager/Lead Senior Coder Location: Remote Contract Type: Full-Time Clearance: No Secret Clearance Required Starting Salary: $58.00/Hour “Candidates must hold valid credentials from either AAPC or AHIMA to be eligible to apply.” Please indicate the position(s) you’re applying for on our website application when you apply online. This will help our team track your application process. Include your full mailing address (for equipment shipment), desired start date, and AAPC and/or AHIMA certification number(s) (with expiration date). https://gopacgroup.com/mid-level-manager-lead-senior-coder/ If you have already applied for this position and taken the Assessment, please do not apply again. The Assessment is the same for all the positions. If you have your score and you are getting updates, please do not apply again. Assessment Protocol The assessment is strictly timed and must be completed within 1 hour ....

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Full Time

Senior Risk Adjustment Coder (CPC, CRC, and CCDS required) - Remote/CA Resident

Stanford Medicine Partners Remote (CA, USA)

Senior Risk Adjustment Coder (CPC, CRC, and CCDS required) Stanford Medicine Partners Newark, CA (Remote/CA Resident) Stanford Medicine Partners (SMP) is looking for an amazing Senior Risk Adjustment Coder to join our rapidly growing team! SMP prides itself in offering exceptional service and patient care. Stanford Medicine Partners with Stanford Health Care to provide individualized and convenient care with access to Stanford specialists and technology. Join our team and start making a difference today! A Brief Overview The Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment. What you will do Risk Adjustment...

Full Time

Director, Compliance, Medical Coding (Remote)

Kaiser Permanente Remote (Washington, DC, USA)

When you join Kaiser Permanente, you’ll be part of an organization dedicated to total health. At every level and in every department, it’s what we stand for. By using your innovation and your creativity, you can play a role in the health of communities across town and around the country by serving 12.5 million of our members. No matter your background, your ideas can help drive a health care pioneer. You can play a role in the future of health. Director, Compliance, Medical Coding (Remote) Oakland, California Full-Time, Salary Range: $192,200 – $248,710/Year ******This is a 100% remote position, and you may be based in any of the following Kaiser Permanente locations: CA, GA, CO, OR, WA, VA, MD, or Washington, D.C. In addition to the responsibilities listed below, the position is also responsible for serving as a Risk Adjustment compliance subject matter expert related to coding functions, overseeing audit activity related to coding...

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Health Risk Adjustment Coder

Blue Zones Health CA, USA

Job Description:At Blue Zones Health we are redefining what it means to live a vibrant and healthy lifestyle. Inspired by long-living cultures around the world, we strive to empower people to make simple and sustainable lifestyle changes that lead to longer, better and more fulfilling lives. If you are ready to help transform well-being and be a pivotal part of our team, we want to meet with you! Position Summary This position will own assigned client relationships, acts as a subject matter expert, and oversees the development and facilitation of the implementation of new and existing healthcare Risk Adjustment & Quality strategies at an advanced level. Guides and influences other departments and the lead on quality and risk adjustment initiatives. Local Provider support for short- and long-term strategy, program planning and implementation, patient campaigns, outreach tactics, facilitation educational programs, data collection efforts and develops and monitors key performance...

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Coder II

Geisinger Raleigh, NC, USA

Health Information Coding Specialist Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient...

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Coder IV - Claim Edits Coder (medical coding)

Geisinger Nashville, TN, USA

Health Information Coding Specialist Health Information Coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient severity and...

DJ

Network Practice Coder/Auditor

Direct Jobs Valhalla, NY, USA

Job Summary The Coder is responsible for auditing medical records, including applicable diagnoses and operative/ diagnostic procedures in patient medical records, using the current International Classification of Diseases (ICD), Current Procedural Terminology (CPT) and Health Care Financing Administration Common Procedures Coding System (HCPCS) and identifying opportunities for improvement as well as assuring compliance with coding and documentation guidelines. In addition the coder is responsible to provide education and training to providers and other agency coders based on the findings of the medical records audits. Does related work as required. Responsibilities Using the current HCPCS, ICD and CPT coding guidelines, audits medical records for coding for accuracy Identifies patterns and opportunities requiring provider education. Works with providers and office staff to educate on proper coding and documentation. Identifies service-specific/provider specific trends for...

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Medical Coding Compliance Specialist - Remote (US)

Theoria Medical Novi, MI, USA

Job Description Job Description Medical Coding Compliance Specialist Compensation: Up to $85,000 annually, determined by your experience and qualifications. Job Location: Remote (US) Job Highlights: Work-Life Balance: Monday to Friday schedule for a fulfilling personal and professional life. Competitive Compensation: Be rewarded with a generous salary and benefits package. Career Growth Opportunities: Unlock your potential and advance in your career with our support. Supportive Work Environment: Join a team that values and appreciates your contributions. Comprehensive Training: Enhance your skills and knowledge through our extensive training programs. Compliance and Peace of Mind: Work with confidence knowing that we prioritize compliance with employment laws and regulations. Paid Time Off and Holidays: Enjoy well-deserved time off to relax and recharge. Life Insurance Coverage: Protect your loved ones with our employer-paid life insurance...

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VMG Risk Adjustment Coder - CRC within 6 months! (Remote)

Virtua Health Baton Rouge, LA, USA

Virtua Health Coding Specialist Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). CRCs review provider documentation and communicates coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models. Position Responsibilities: Evaluates and analyzes medical records for proper documentation. Identifies and communicates coding deficiencies to clinicians in order to improve documentation for accurate risk adjustment coding. Provides on-going training and education to the clinicians and physicians during 1:1, physician group, performance improvement and ad hoc meetings. Manages and trends data collection for HCC and other...

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Coder II

Geisinger Cincinnati, OH, USA

Health Information Coding Specialist Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient...

VH

VMG Risk Adjustment Coder - CRC within 6 months! (Remote)

Virtua Health Brookhaven, NY, USA

Virtua Health Coding Specialist Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). CRCs review provider documentation and communicates coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models. Position Responsibilities: Evaluates and analyzes medical records for proper documentation. Identifies and communicates coding deficiencies to clinicians in order to improve documentation for accurate risk adjustment coding. Provides on-going training and education to the clinicians and physicians during 1:1, physician group, performance improvement and ad hoc meetings. Manages and trends data collection for HCC and other...

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Certified Medical Coder

Lamoille Health Partners Morristown, VT, USA

Job Description Job Description Lamoille Health Partners is looking for a Certified Medical Coder to accurately translate diagnostic and procedural information from patient medical records into standardized codes. The Medical Coder plays a crucial role in ensuring accurate billing and reimbursement, as well as contributing to valuable healthcare data collection. ESSENTIAL FUNCTIONS: Review and analyze patient medical records, including physician notes, operative reports, laboratory and radiology results, and discharge summaries, to identify pertinent diagnoses and procedures. Accurately assign ICD-10-CM, CPT, and HCPCS codes according to official coding guidelines and regulations. Ensure proper sequencing of codes to optimize reimbursement and meet payer requirements. Abstract relevant information from medical records, including patient demographics, diagnoses, procedures, and dates of service. Identify and resolve coding discrepancies, errors, and omissions by...

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Edits Coder

Seattle Staffing Seattle, WA, USA

Coding Specialist 1 - Edits Coder UW Medicine Enterprise Records and Health Information has an outstanding opportunity for a Coding Specialist 1 - Edits Coder. The Edits Coder position reports to the Outpatient Coding Supervisor within the Enterprise Records and Health Information Management department. Under the general supervision of the Manager of Facility Coding, and the direct supervision of the Supervisor of Outpatient Coding, the Edits Coder is responsible for implementing the mission and goals of Enterprise Records and Health Information, and incorporating a "patients are first" service culture. The Edits Coder is responsible for performing daily activities related to analyzing medical records to validate the correct coding assignment of International Classification of Disease (ICD), Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/Risk Adjustment...

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Edits Coder

Washington Staffing Seattle, WA, USA

Coding Specialist 1 - Edits Coder UW Medicine Enterprise Records and Health Information has an outstanding opportunity for a Coding Specialist 1 - Edits Coder. The Edits Coder position reports to the Outpatient Coding Supervisor within the Enterprise Records and Health Information Management department. Under the general supervision of the Manager of Facility Coding, and the direct supervision of the Supervisor of Outpatient Coding, the Edits Coder is responsible for implementing the mission and goals of Enterprise Records and Health Information, and incorporating a "patients are first" service culture. The Edits Coder is responsible for performing daily activities related to analyzing medical records to validate the correct coding assignment of International Classification of Disease (ICD), Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/Risk Adjustment...

DJ

HCC Coding Auditor Senior - Health Plan Admin

Direct Jobs Irving, TX, USA

Description Summary: The HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment....

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Physician Coder I

Memorial Healthcare System Miramar, FL, USA

Talent Sourcing Specialist at Memorial Healthcare System Overview Summary: Reviews 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. Responsibilities Reviews medical record documentation to determine all appropriate diagnostic, procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. May assign and sequence diagnostic, CPT (Current Procedural Terminology) procedure codes (minimal) and modifiers based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP) guidance in encoder software and/or department coding policies and procedures. Using encoder, reviews Ambulatory...

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Lead Risk Adjustment Coder

Augusta Health Fishersville, VA, USA

Join to apply for the Lead Risk Adjustment Coder role at Augusta Health 7 months ago Be among the first 25 applicants Join to apply for the Lead Risk Adjustment Coder role at Augusta Health The Lead Risk Adjustment Coder is a system support position who completes coding and abstracting of patient encounters for the purposes of analyzing and improving the accuracy of complexity capture. The specialist works closely with physicians, the Population Health quality and data teams, the coding teams in AMG and the hospital, and the compliance department to identify and deliver high quality and accurate risk adjustment coding. The Lead Risk Adjustment Coder will demonstrate strong understanding of ICD-10-CM, CPT, HCC, and HCPCS coding guidelines and practices for outpatient and inpatient coding. Education High school diploma or equivalent is required 2 years of completed college coursework is preferred Licensure/Certification Certified Professional Coder thru AAPC Certified in...

UH

Compliance Auditor, Billing and Coding Compliance

UT Health San Antonio San Antonio, TX, USA

Compliance Auditor, Billing and Coding Compliance Join to apply for the Compliance Auditor, Billing and Coding Compliance role at UT Health San Antonio Compliance Auditor, Billing and Coding Compliance 2 weeks ago Be among the first 25 applicants Join to apply for the Compliance Auditor, Billing and Coding Compliance role at UT Health San Antonio Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Description The Compliance Auditor, Billing and Coding...

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Project Coordinator - Medical Policy UMC Coder (Hybrid - Troy, MI) - Health Alliance Plan

Henry Ford Hospital Troy, MI, USA

Business (Non-Clinical) Project Coordinator As an integral member of the HAP Medical Policy Team, the Project Coordinator will be responsible for research and guidance on coding such as CPT, HCPCS, ICD used in the development and maintenance of Benefit Administration Manual policies and HAP's coverage tool (Master Tiering Database) as well as actively participate in various HAP code-related committees and ad hoc projects. Principal Duties and Responsibilities: Conduct research for development and update of codes for Benefit Administration Manual policies and the Master Tiering Database, requests by the Utilization Management Committee and HAP code-related committees, and other issues such as new technology. Maintain organized documentation of findings from research as well as proposed resolutions. Research all types of codes (e.g., CPT, HCPCS, ICD) including new codes, existing codes, additions and deletions of codes, use of modifiers, and revenue codes to be compliant with...

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Coder II

Geisinger Dallas, TX, USA

Health Information Coding Specialist Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient...

41 medical risk adjustment specialist jobs found