69 risk adjustment coder ii jobs found

Community Health Choice, Inc. seeks a Risk Adjustment Coder II in Houston, Texas. The role involves advanced medical record reviews and coding of chronic conditions to ensure correct risk scoring, complying with CMS guidelines and internal policies. The ideal candidate has a Bachelor's degree or equivalent experience, and AHIMA/AAPC certification, along with 3-5 years of experience in risk adjustment coding. Join a team dedicated to improving healthcare quality for over 400,000 members. #J-18808-Ljbffr

Company Overview 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,...

Risk Adjustment Coder IIThe Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization.Job Specifications and Core Competencies:Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk...

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 Childrens 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,...

Millennium Physician Group in Florida is seeking a risk adjustment coding reviewer who performs independent reviews of patient records to validate diagnosis coding accuracy and documentation support. You will apply ICD-10-CM guidelines, HCC methodologies, and Medicare risk adjustment requirements to identify coding opportunities and areas for documentation improvement. Under moderate supervision, you will analyze clinical notes, communicate findings to providers, and participate in process #J-18808-Ljbffr

Millennium Physician Group, a large Florida-based primary care network, seeks a risk adjustment coding reviewer to validate diagnosis coding accuracy through independent clinical record reviews and documentation support. The role supports Medicare risk adjustment initiatives and improves coding integrity within a value-based care framework. Under moderate supervision, you will abstract codes, analyze trends, and communicate findings to providers and internal stakeholders, contributing to #J-18808-Ljbffr

## Risk Adjustment Coder IIIApply: Hybrid: Miami, FL: Full time: Posted 2 Days Ago: JR4418It's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.**Job Summary**The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.**Duties & Responsibilities****Essential Duties & Responsibilities*** **Medical Coding and Documentation*** Assign ICD-10-CM diagnosis codes based on medical...

Cano Health in Miami, FL is seeking a Risk Adjustment Coder III to join our hybrid team. You will assign ICD-10-CM codes, review charts, and ensure accurate HCC capture in line with CMS guidelines. The role requires meticulous documentation and collaboration with clinical staff to support patient care analytics. We expect at least 5 years of medical coding experience with a CPC or CCS certification. Strong analytical and communication skills are essential, and you will participate in audits #J-18808-Ljbffr

Risk Adjustment Coder III It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit. Duties & Responsibilities Essential Duties & Responsibilities Medical Coding and Documentation Assign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in...

Cano Health in Miami, FL is seeking a Risk Adjustment Coder III to join our hybrid team. You will assign ICD-10-CM codes, review charts, and ensure accurate HCC capture in line with CMS guidelines. The role requires meticulous documentation and collaboration with clinical staff to support patient care analytics. We expect at least 5 years of medical coding experience with a CPC or CCS certification. Strong analytical and communication skills are essential, and you will participate in audits #J-18808-Ljbffr

Claremedica Health Partners LLC is seeking an accurate Risk Adjustment Coder to join our team in a detail-oriented role focused on reviewing medical records and coding for risk adjustment models. You will verify documentation, ensure ICD-10-CM and CPT guideline adherence, and help maintain regulatory compliance across Federal and State programs. Applicants should have CPC certification and ideally CRC certification, with 3+ years of medical coding experience and proficiency in EMR software and #J-18808-Ljbffr

Claremedica Health Partners LLC is seeking an accurate Risk Adjustment Coder to join our team in a detail-oriented role focused on reviewing medical records and coding for risk adjustment models. You will verify documentation, ensure ICD-10-CM and CPT guideline adherence, and help maintain regulatory compliance across Federal and State programs. Applicants should have CPC certification and ideally CRC certification, with 3+ years of medical coding experience and proficiency in EMR software and #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

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...

Millennium Physician Group in Indiana is seeking a Risk Adjustment Coding Specialist II to review patient records after visits and translate documentation into provider-selected ICD-10-CM codes for claims processing. You will collaborate with the MRA Department to validate codes to the highest specificity, identify missing information, and maintain professional certifications while ensuring HIPAA compliance and timely submissions. #J-18808-Ljbffr

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coder/Educator Full-Time-40 Asheville, NC, US Salary Range: $24.00 To $29.00 Hourly Mercy Urgent Care is seeking a Medical Coder/Educator to support the integrity of our revenue cycle and ensure accurate, compliant coding for urgent care and occupational health services. This role is ideal for an experienced coder who enjoys accuracy, problem-solving, education, and collaboration within a fast-paced mission-driven healthcare environment. You’ll work closely with providers, billing, and revenue cycle teams to ensure documentation supports coding, payer requirements are met, and reimbursement is optimized—all while maintaining the highest standards of compliance. About the Role As our Medical Coder/Educator, you’ll code accurately and help our providers and staff document and code better. You’ll audit for...

Join Carina Health Network Help us make Colorado communities healthier! Are you passionate about population health and interested in improving patient experience and outcomes? If so, we support several community health organizations (CHO), and this company is for you! At Carina Health Network, we are transforming community health by delivering proactive, data-informed, and whole-person care that drives measurable impact. Our work helps people stay healthier longer, by supporting community health organizations who have patients with chronic conditions like diabetes and high blood pressure, ensuring regular check-ups for older adults, and identifying mental health needs early. We help community health organizations prevent costly ER visits by connecting people with the right care at the right time. Through our value-based care programs, we empower frontline care teams to improve outcomes while earning fair, sustainable reimbursement. By saving money and reinvesting in community...

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....

Astrana Health Management in Houston is seeking a Risk Adjustment Coding Specialist II to drive risk adjustment efforts through chart reviews, provider education, and KPI reporting. You’ll translate findings into actionable insights and support education for providers and practice leaders while navigating complex conversations. Candidates should have 3–5 years in risk adjustment, CPC/CRC credentials, travel up to 75%, and strong communication skills. #J-18808-Ljbffr

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 We are an...

Value Based Coder II Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. 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...

Description The Inpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Inpatient Coder II is the coding and reimbursement expert for ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for complex inpatient acute care discharges. Possesses a strong foundation in coding conventions, instructions, Official Guidelines for Coding and Reporting and Coding Clinics. Has a deep understanding of disease process, anatomy/physiology, pharmacology and medical terminology. RESPONSIBILITIES: Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes to complex inpatient visit types. Complexity is measured by a Case Mix Index (CMI) and Coder II's typically see average CMI's of 2.2609. This index score demonstrates higher patient complexity...

Job TitleREMOTE positionWebEx video interview will be conducted prior to an offerMUST be able to work 40 hrs/week without issueApplicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera. If not, Agency must supply ahead of start date.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 proceduresVaccinationsE/M levelingModifiers: 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 MedicineCardiologyChronic Kidney DiseaseTransplant...

Risk Adjustment Coder 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...