42 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

CommonSpirit Health is seeking a Value Based Coder II in Houston, Texas. This role involves reviewing patient medical records to identify coding opportunities with a focus on Hierarchical Condition Categories (HCC). You will develop provider education and actively support process improvement initiatives. The ideal candidate will have at least 2 years of outpatient coding experience, advanced knowledge of coding guidelines, and the ability to communicate effectively with providers. Join us in enhancing healthcare quality through precise coding and compliance. #J-18808-Ljbffr

A healthcare company seeks a Risk Adjustment Coding Specialist II in Orange, CA. The role involves reviewing medical records, educating providers, and performing coding audits. Candidates must have strong coding skills and certifications, along with 3-5 years of risk adjustment experience. This position requires up to 75% travel to provider offices and follows a hybrid work structure, allowing flexibility in work location. Competitive pay ranges from $70,000 to $85,000 per year. #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

A healthcare organization is seeking a Risk Adjustment Coding Specialist II to support risk adjustment efforts in Beaumont, Texas. The ideal candidate will have 3-5 years of experience in risk adjustment coding and should be capable of conducting chart reviews, educating providers, and improving coding accuracy. The position involves up to 75% travel and requires AAPC or AHIMA certification. A compensation range of $70,000 - $85,000 is offered, along with a hybrid work structure. #J-18808-Ljbffr

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment coding and...

Where You'll Work Baylor St. Luke's Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke's Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke's also has three community emergency centers offering adult and pediatric care for the Greater Houston area. 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...

Coding Specialist II Fully remote position! Applicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera. If not, Agency must supply ahead of start date. The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters. This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. This position requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland's policies to ensure accuracy of recorded patient medical information and...

Medical Coder II This position has a deep understanding of disease process, A&P and pharmacology and acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service. Position Highlights: Position: Medical Coder II Location: Warrenville, IL Full Time/Part Time: Full Time Hours: Monday-Friday, day shift What you will do: Assigns diagnostic and procedure codes for compliant physician reimbursement and for both evaluation/management, preventive (HCC risk adjustment) and surgical services under general supervision. Communicates daily regularly with physicians and staff to resolve discrepancies with patient records and coding selections. Performs provider audits on E/M (evaluation/management) services and HCC review on Medicare/Medicare Advantage preventive services and educates providers as needed. Trains physicians and other staff regarding documentation, billing and coding, and documentation. What...

AltaStaff is a staffing agency currently looking for a Certified Medical Coder II (Coding Specialist) to work with our Managed Care Client! Must have an active medical Coding Certification (CIC or CCS) Pay Rate: $20.00 - 21.50 hourly Shift: Monday-Friday, 8am-4:30pm This role is fully remote, but candidates must reside in one of the following states: NY, FL, GA, MI, OH, WI, IA, NM, TX or KY Qualified candidates must have experience specifically with facility inpatient coding! Summary: This position serves as the primary resource for medical coding updates and information. Advises the client on coding issues, provides in-depth research on new or unusual procedures, and makes recommendations when appropriate. Responsibilities: Performs on-going chart reviews and abstracts diagnosis codes Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly Coordinate with Clinical...

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)...

Outpatient Clinical Documentation Specialist The Risk Adjustment CDS will provide clinically based prospective concurrent and retrospective reviews of medical records for WellSense of members enrolled in value-based agreements to evaluate risk adjustment capture based on clinical documentation. The Risk Adjustment CDS will review risk adjustment gap lists for members including suspect conditions and perform chart reviews to determine clinical validity of open gaps. The Risk Adjustment CDS will utilize Physician documentation queries to communicate clinical indicators to Physicians/Other Qualified Health Care Providers in preparation for up-coming visits and/or in identifying patients that need to be seen for a visit. The goal of the risk adjustment reviews includes facilitation of appropriate physician documentation of care delivery to accurately reflect patient severity of illness and risk of mortality. Specific reviews are both determined internally and by requirements/requests...

Porter is hiring a Risk Adjustment Coder to join our Team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health...

Risk Adjustment Coder Denver, CO 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...

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...

Who You Are You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role As a Lead CDI Coder you are responsible for partnering with physician offices within our established partnerships to assist in translating healthcare documentation into standardized codes, ensuring accurate coding and billing of patient encounters, as supported by the medical record. You serve as a subject matter expert in Coding and Documentation. Role...

Overview: The Documentation and Coding Consultant 1 provides training, consultation, review, and feedback to clinicians on their medical service documentation and coding to ensure KPNW receives appropriate reimbursement and conforms to applicable guidelines and regulations. This is a hybrid position that is a blend of working both remotely and in office. Must reside in the Northwest Service Region (Oregon or Washington). Major Responsibilities / Essential Functions: Consulting and Coding services Provides expert consultation to specialists or primary care clinicians as assigned on coding and documentation education and questions. Within assigned clinical specialties, maintain current knowledge to ensure that KPNW coding and documentation meets regulatory guidelines and audit standards. Follow coding specificity guidelines using coding rules and guidelines. General coding knowledge and understanding of Risk Adjustment models and submission...

GoTo Telemed seeks an exceptional Remote Medical Biller to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide.As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers--with new clients and provider networks added every month as our organization scales.In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management.Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory.This position...

Knowledge and Expertise: Must demonstrate a solid understanding of Coding Guidelines and CPT Guidelines for E/M (Evaluation and Management). Must be able to answer questions to gauge their coding knowledge. Clinic Coding Experience: Must have experience in clinic coding, including: Office-type procedures Vaccinations E/M leveling Modifiers: Familiarity with modifiers used in the clinic setting is essential. Risk Adjustment Experience: While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding experience as well. Experience in Specialty Areas: The candidate must have experience in at least five (5) of the following areas: Internal Medicine Cardiology Chronic Kidney Disease Transplant Clinic Orthopedics Rheumatology Dermatology Acute Response Care (ARC) Follow-Up Surgery HIV/AIDS Sleep Center Pediatrics OB Clinic OB Complications OB Triage Hospitalist Inpatient Specialties...

Knowledge and Expertise: Must demonstrate a solid understanding of Coding Guidelines and CPT Guidelines for E/M (Evaluation and Management). Must be able to answer questions to gauge their coding knowledge. Clinic Coding Experience: Must have experience in clinic coding, including: Office-type procedures Vaccinations E/M leveling Modifiers: Familiarity with modifiers used in the clinic setting is essential. Risk Adjustment Experience: While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding experience as well. Experience in Specialty Areas: The candidate must have experience in at least five (5) of the following areas: Internal Medicine Cardiology Chronic Kidney Disease Transplant Clinic Orthopedics Rheumatology Dermatology Acute Response Care (ARC) Follow-Up Surgery HIV/AIDS Sleep Center Pediatrics OB Clinic OB Complications OB Triage Hospitalist Inpatient Specialties Inpatient Newborn Inpatient...

Coder II - ProFee Surgery Abstracts data from medical records into Epic and 3M 360 to provide a detailed case summary of medical, demographic, and statistical information. Identifies and codes diagnoses and procedures for medical records according to ICD-10-CM and CPT-4 guidelines, including department modifications. Identifies primary diagnosis and procedure as well as pertinent secondary diagnoses and procedures. Follows procedures mandated by government and other payers for completion of coded data including APC assignments. Includes inpatient E/M coding and clinic E/M coding as well as trauma surgery coding and bedside procedure coding. Experience required in at least E/M coding or trauma surgery coding. Facility Specific: Responsible for coding SDS, Observation, and as needed ED, Diagnostic, and Ancillary records. Professional Fee Specific: Responsible for coding Surgical Records, Evaluation & Management Encounters, ED (with E&M) and as needed Diagnostic, HCC,...

Who We Are 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...

Job Summary The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Job Specific Competencies Team Leadership & Oversight Supervises coding staff including Coder I and Coder II. b. Monitors productivity and quality metrics, ensuring standards are met or exceeded. c. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. b. Ensures adherence to federal, state, and payer-specific coding guidelines. c. Coordinates with Compliance and Revenue...

Medical Coding Supervisor The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Team Leadership & Oversight: Supervises coding staff including Coder I and Coder II. Monitors productivity and quality metrics, ensuring standards are met or exceeded. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance: Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. Ensures adherence to federal, state, and payer-specific coding guidelines. Coordinates with Compliance and Revenue Cycle teams to resolve audit findings...