249 risk adjustment coder jobs found

Certified Risk Adjustment Coder (CRC) Hybrid | Des Moines, IA (Onsite TuesThurs, Remote Mon/Fri) $40/hour | 6-Month Contract with Potential for Conversion We are seeking a Certified Risk Adjustment Coder (CRC) to support Medicare Risk Adjustment initiatives through detailed HCC medical record reviews and direct provider engagement. This role is ideal for someone confident, collaborative, and comfortable working onsite with provider teams to drive documentation accuracy and performance improvement. This position requires onsite presence TuesdayThursday in Des Moines, IA with 10% local travel , and remote flexibility on Mondays and Fridays. Position Overview This role performs concurrent medical record reviews to ensure accurate capture of HCC conditions and appropriate documentation reflecting patient severity of illness. The coder will collaborate closely with physicians, clinical leadership, and provider engagement teams to improve documentation practices...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Risk Adjustment Coder McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Position Overview: The...

Job Description Position Purpose: This position is responsible for ongoing risk adjustment improvement activities. Under general supervision, this position includes ongoing quality improvement activities to ensure the organizations Risk Adjustment programs are implemented and meet all government requirements. Nature and Scope: This role does not manage people.

Certified Risk Adjustment Coder We are seeking a detail-oriented Certified Risk Adjustment Coder to join our healthcare team. This role involves working directly within a clinical or administrative unit to ensure accurate and compliant coding of medical procedures, diagnoses, and services. The ideal candidate will be embedded in day-to-day operations, collaborating closely with physicians, nurses, and billing staff to support efficient documentation and reimbursement processes. This is a hybrid role, and requires 3 days a week in the office Key Responsibilities: Review and analyze patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes. Ensure coding accuracy and compliance with federal regulations, payer policies, and internal standards. Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies. Submit coded data to billing systems to initiate insurance claims and support reimbursement. Maintain and update patient...

Outpatient Risk Adjustment Coder IHCI Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered and we couldn't do it without you. The Innovative Healthcare Collaborative of Indiana LLC (IHCI) is a company formed through the partnership of Community Health Network (CHNw) and Deaconess Health System (DHS). Both CHNw and DHS place high importance on continuing and advancing population health and value-based care to improve patient health outcomes. Reporting to the Clinical Documentation Integrity...

Risk Adjustment Coder TEP-Health Employees Temporary Employment 88274BR Job Summary Employment Duration: 3 months Location: Fully Remote Openings: 2 The Health Information Coder I is an entry-level coder with a basic knowledge and skill set to utilize ICD-10-CM, CPT, and HCPCS classification systems to code across various healthcare settings, including outpatient, emergency department, and ancillary services. This role ensures coding accuracy, compliance with regulatory guidelines, and adherence to UCSF policies, supporting proper reimbursement and revenue cycle integrity. The Coder I collaborates with healthcare providers, revenue cycle teams, and compliance departments to resolve documentation issues and maintain high standards of coding performance. This position is hybrid and may require travel to UCSF Health for business purposes. The incumbent must be able to provide a safe and private home office environment for conducting UCSF business. Key...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Coder, Risk, Specialist, Healthcare, Medical

A nonprofit health care organization in New York is seeking a Coding Specialist to ensure compliance in medical record documentation. The successful candidate will conduct coding reviews, monitor ICD-10 coding accuracy, and assist healthcare providers with documentation requirements. This role requires a strong understanding of medical terminology and claims processing, with at least two years of relevant experience. The organization values innovation and provides extensive benefits, including generous paid time off and professional growth opportunities. #J-18808-Ljbffr

Peak Performers has partnered with a healthcare organization to assist in their search for a remote Sr. Risk Adjustment Coder. In this position, you will be responsible for reviewing and analyzing medical records, validating diagnosis codes, and supporting risk adjustment audit activities to ensure accurate reporting to government programs. Major Duties Review and code inpatient and outpatient medical records using ICD-10 guidelines for risk adjustment purposes. Analyze and validate diagnosis coding to ensure accuracy and compliance with CMS risk adjustment and HCC guidelines. Support Risk Adjustment Data Validation (RADV) audits by reviewing historical audits and assisting with third-pass coding reviews. Assist with quality assurance of documentation packages prior to submission to government agencies. Identify trends in coding data and contribute to reporting efforts such as HCC trend tracking and audit analysis. What are we looking for? Associate’s or Bachelor’s degree...

A healthcare staffing agency is seeking a Sr. Risk Adjustment Coder to work remotely. In this role, you will review medical records and validate diagnosis codes to support government programs. The ideal candidate should have over 5 years of risk adjustment coding experience and relevant certifications. This position offers a contract at $31.34/hour with possible extensions. Benefits include medical insurance and a retirement plan. #J-18808-Ljbffr

A prominent healthcare institution is seeking an entry-level Health Information Coder I. This fully remote role involves coding various healthcare settings using ICD-10-CM, CPT, and HCPCS classification systems. The ideal candidate will ensure coding accuracy and compliance with UCSF policies while working with healthcare providers and revenue cycle teams. Emphasis on productivity, quality benchmarks, and maintaining high standards is essential. Qualifications include a high school diploma and CRC certification, with preferred experience in coding. #J-18808-Ljbffr

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...

Senior Risk Adjustment Coder 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. Locations: Stanford Health Care - University Healthcare Alliance What You Will Do Risk Adjustment Review May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing Reviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses. Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes. Inquire with clinicians the recommended HCC diagnosis for chart addendum. Collaborating with...

We are looking for experienced HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. Essential Duties and Responsibilities include the following: Works as an integral member of the Finance Department. Code review super bills and patient medical records for proper use of diagnosis and...

Risk Adjustment Coder Specialist Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required...

A health care organization seeks an HCC Risk Adjustment Coder in a hybrid setting. The role requires expertise in coding, data management, and medical terminology, along with a minimum of an associate's degree. Responsibilities include abstracting diagnosis codes, managing data entry, and supporting the Population Health Department. Competitive compensation, benefits, and annual bonuses are offered, reflecting the organization's commitment to employee growth and satisfaction. #J-18808-Ljbffr

HealthCare Support is seeking a Risk Adjustment Coder - Hybrid to join a mission-driven healthcare organization in Monterey Park, CA . This full-time, salaried role offers the flexibility of hybrid work combined with in-market provider engagement. Schedule: Monday - Friday, 8:00 AM - 5:00 PM PST Compensation: $75K - $85K (negotiable based on experience) What Makes This Role Stand Out Strong Work-Life Balance with a primarily remote schedule Provider-facing education and real-world impact in risk adjustment Opportunity to serve as a senior resource, mentor, and subject matter expert Competitive compensation and comprehensive benefits package Benefits For The Risk Adjustment Coder - Hybrid Medical, Dental, and Vision Insurance Complimentary access health plan option 401(k) Retirement Plan with match Paid Time Off (PTO) Employee Stock Purchase Plan Daily Responsibilities For The Risk Adjustment Coder - Hybrid Review and audit medical records for accurate ICD-10 and HCC risk adjustment...

HealthCare Support is seeking a Risk Adjustment Coder - Hybrid to join a mission-driven healthcare organization in Monterey Park, CA . This full-time, salaried role offers the flexibility of hybrid work combined with in-market provider engagement. Schedule: Monday - Friday, 8:00 AM - 5:00 PM PST Compensation: $75K - $85K (negotiable based on experience) What Makes This Role Stand Out Strong Work-Life Balance with a primarily remote schedule Provider-facing education and real-world impact in risk adjustment Opportunity to serve as a senior resource, mentor, and subject matter expert Competitive compensation and comprehensive benefits package Benefits For The Risk Adjustment Coder - Hybrid Medical, Dental, and Vision Insurance Complimentary access health plan option 401(k) Retirement Plan with match Paid Time Off (PTO) Employee Stock Purchase Plan Daily Responsibilities For The Risk Adjustment Coder - Hybrid Review and audit medical records for accurate ICD-10 and HCC risk adjustment...

HealthCare Support is seeking a Risk Adjustment Coder - Hybrid to join a mission-driven healthcare organization in Monterey Park, CA . This full-time, salaried role offers the flexibility of hybrid work combined with in-market provider engagement. Schedule: Monday - Friday, 8:00 AM - 5:00 PM PST Compensation: $75K - $85K (negotiable based on experience) What Makes This Role Stand Out Strong Work-Life Balance with a primarily remote schedule Provider-facing education and real-world impact in risk adjustment Opportunity to serve as a senior resource, mentor, and subject matter expert Competitive compensation and comprehensive benefits package Benefits For The Risk Adjustment Coder - Hybrid Medical, Dental, and Vision Insurance Complimentary access health plan option 401(k) Retirement Plan with match Paid Time Off (PTO) Employee Stock Purchase Plan Daily Responsibilities For The Risk Adjustment Coder - Hybrid Review and audit medical records for accurate ICD-10 and HCC risk adjustment...