48 risk adjustment coder ii jobs found

About Us Community Health Choice, Inc. (Community) is a non‑profit managed care organization 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 programs including the Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women; the 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 offering individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions; and the Community Health Choice HMO D‑SNP, a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid. Improving members’ experiences is at the heart of every Community...

Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines. The role supports Commercial and Medicare risk adjustment programs and helps ensure accurate documentation and coding. The coder will contribute to trainings, audits, and collaboration across departments to improve documentation quality and compliance. #J-18808-Ljbffr

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, Medicare...

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,...

Galen Medical Group is seeking an EMR Coding Auditor II to improve documentation quality and ensure HCC coding accuracy. You will review charts, validate chronic conditions, and coordinate with physicians to maintain up-to-date problem lists in the EMR. You will train new staff and support the team under the Population Health Manager. The role requires expertise in ICD-10/CPT, strong communication skills, and a commitment to quality and compliance. #J-18808-Ljbffr

Astrana Health seeks a Risk Adjustment Coding Specialist II to join our Strategy and Operations team in Monterey Park, CA. The role requires converting provider documentation into compliant HCC coding and educating providers on CMS requirements while traveling to provider sites as needed. Qualified candidates hold CCS/CPC certification with 3+ years of risk adjustment coding experience, strong EHR skills, and the ability to work in a hybrid setting, including on-site visits and remote #J-18808-Ljbffr

Risk Adjustment Coder IIIIt'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 SummaryThe 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 & ResponsibilitiesEssential Duties & ResponsibilitiesMedical Coding and DocumentationAssign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in accordance with established...

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. Position eligible for Telecommuting with consideration for a fully remote arrangement within Washington State, depending on experience (DOE) 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...

Porter is hiring a Risk Adjustment Coder to join our Team! Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in‑home health assessments. The ideal candidate will have a strong understanding of CMS risk adjustment and quality initiatives, exceptional attention to coding quality, and experience managing the provider query process. This role also requires the ability to handle multiple clients each with unique coding requirements while ensuring accuracy and compliance. Proficiency in utilizing coding clinics for provider education and feedback is essential. This role will be instrumental in ensuring the accuracy of coding and improving the efficiency of our assessment workflows. A key expectation is that the Risk Adjustment Coder will maintain 98% coding accuracy. Schedule: Monday - Friday (some weekends and overtime) Start: 8am-8:30am ET On-site: Pompano Beach, FL *This is not a lead or manager position Key...

Millennium Physician Group seeks a Level II Risk Adjustment Coding Specialist to abstract ICD-10-CM codes from encounter documentation, conduct audits, and contribute to VBAT and MRA analyses in New York. The role requires 2+ years of coding experience, including 1 year of HCC coding, and strong knowledge of ICD-10-CM conventions, with proficiency in MS Office and EMR systems. You will collaborate with leadership to meet accuracy and productivity targets. #J-18808-Ljbffr

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

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. Position eligible for Telecommuting with consideration for a fully remote arrangement within Washington State, depending on experience (DOE) 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...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you’re interested in joining a health care system that is changing the face of care and well-being in our community, we encourage...

University of Wisconsin Medical Foundation Medical Coding Specialist II- Orthopedics/Multi Spec (Finance) 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 List Qualifications Medical Coding education required. In lieu of a Medical Coding education, an active coding certification is required. High School diploma or equivalent preferred Associate's Degree in a healthcare related field preferred Work Experience 1 year of progressive coding experience required 2 years progressive coding experience in multiple specialties, HCC Risk adjustment Coding preferred Licenses &...

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...

2 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. This range is provided by SNI Companies. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $17.00/hr - $21.00/hr Direct message the job poster from SNI Companies SNI Companies is looking for a Medical Biller. The ideal candidate will have prior experience in patient billing and medical claims/insurance management. This is a full-time position with remote flexibility. The Medical Biller is responsible for verifying patient insurance, managing insurance claims, and billing/reimbursement processes. We are looking for a detail-oriented individual with excellent patient/customer service skills. Responsibilities: Verify patient insurance coverage Patient billing - resolving discrepancies and communicating with insurance companies Communicating with patients regarding billing inquiries and...

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 II Red Lodge, MT, US 6 days ago Requisition ID: 1064 Salary Range: $20.83 To $28.63 Hourly Medical Coder II Status: Part Time (20 hours/week) | Non-Exempt Reports to: Health Information and Technology Manager Purpose and Scope of Position Responsible for reviewing and interpreting medical records, documents, and other patient data to assign appropriate codes for healthcare procedures, diagnoses, and services provided. These codes are used for insurance reimbursement, statistical purposes, and maintaining accurate patient records. Medical coders work closely with healthcare providers, insurance companies, and billing departments. Job Requirements Required Qualifications Education: High school diploma or equivalent. Certification: Certification from a recognized body such as the American Academy of...

Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. Candidates should have 3-5 years of risk adjustment coding experience and be able to travel up to 75% for the role. You will review provider documentation, conduct education sessions, and ensure compliance with coding regulations. AAPC or AHIMA certification is required. The role offers a competitive salary range of $70,000 - $85,000 per year. #J-18808-Ljbffr

Astrana Health, Inc. is looking for a Risk Adjustment Coding Specialist II to support high-volume coding efforts in Orange County. This full-time position offers opportunities to analyze data and educate providers, requiring travel up to 75% of the time. The ideal candidate should have significant experience in risk adjustment coding, critical presentation skills, and a valid driver's license. Compensation ranges from $70,000 to $85,000 per year, depending on experience and location. #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 empowered...

HCC Coding Quality Educator Location: Madisonville, Louisiana, United States of America Category: Clerical Remote: Office/Remote Hybrid Scheduled Weekly Hours: 40 Job Summary: The HCC Coding Quality Educator (HC) facilitates the improved integrity of medical record documentation through interaction with healthcare providers to support the appropriate representation of severity of illness, risk of mortality, acuity, and complexity of care. In addition, this position, through a multidisciplinary team approach, performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure an accurate depiction of the true complexity of the patient to support the facilities Risk Adjustment strategy. The HCQE utilizes their coding knowledge, and demonstrates an understanding of current CMS coding guidelines, the impact of procedures and compliant documentation to support the capture of Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity,...

Risk Adjustment CoderPorter 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 OverviewWe are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home...