15 risk adjustment coder ii jobs found in Houston, TX

A non-profit managed care organization in Texas is seeking a Risk Adjustment Coder II to conduct complex medical record reviews and code chronic conditions accurately. This role requires 3-5 years of experience in risk adjustment coding and relevant certifications. The ideal candidate will ensure compliance with coding guidelines and contribute to departmental goals. Strong analytical and interpersonal skills are essential, along with proficiency in Microsoft 365. This position supports high-quality healthcare access for members. #J-18808-Ljbffr

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription...

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: • Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women • Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR • Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. • Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

A healthcare organization seeks a Risk Adjustment Coder II in Houston, TX. This role involves advanced medical record reviews for accurate risk score calculations and coding per CMS guidelines. Candidates should have a Bachelor's degree or equivalent experience and be AHIMA/AAPC certified. Key skills include ICD-10 coding and strong analytical abilities. This position offers a chance to significantly impact documentation accuracy and departmental goals. Experience in managed care is preferred. #J-18808-Ljbffr

A non-profit managed care organization in Houston is seeking a Risk Adjustment Coder II to provide advanced support for medical record reviews and ensure accurate coding of chronic conditions. The ideal candidate will have a Bachelor's degree or extensive experience in risk adjustment, along with relevant coding certifications. Key responsibilities include coding compliance, conducting documentation reviews, and collaborating with various departments to improve accuracy. A strong background in coding standards and methodologies is essential for this role. #J-18808-Ljbffr

Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children’s Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription...

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 provider organization in Houston seeks a Risk Adjustment Coding Specialist II to ensure compliance with Medicare documentation requirements, conduct audits, and mentor staff. Candidates must have 3-5 years of experience in risk adjustment coding, relevant certification, and reliable transportation for travel. This position follows a hybrid model requiring travel to provider offices, offering a competitive salary between $70,000 and $85,000 per year. #J-18808-Ljbffr

A healthcare organization in Houston seeks an experienced Value Based Coder II to conduct thorough reviews of patient medical records, focusing on Hierarchical Condition Categories (HCC). The role involves delivering provider education, participating in compliance monitoring, and contributing to performance improvement initiatives. Candidates should have a relevant bachelor's degree or equivalent experience, along with coding certifications. Strong knowledge of CPT and ICD-10 coding, risk adjustment models, and excellent communication skills are essential. #J-18808-Ljbffr

A leading healthcare organization in Houston is seeking a Value Based Coder II to join its Quality Management/Risk team. This role is crucial for reviewing patient medical records to identify coding opportunities and deliver provider education on HCC. Candidates should have a Bachelor’s degree or equivalent experience, with at least 5 years in healthcare and certification as a CPC, CCS, or CRC. Strong knowledge of coding guidelines and excellent communication skills are essential. This is an opportunity to contribute significantly to process improvement initiatives. #J-18808-Ljbffr

Value Based Coder II 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. 1. 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. 2. Advanced Documentation...

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 on...

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....

Medical Coder Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM, CPT, and HCPCS Level...

Medical Coder - Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: • Cardiology • Urology • Dermatology • General Surgery • Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review • Accurately assign...