50 risk adjustment coder jobs found in Florida, NY

Baptist Health is seeking a Certified Professional Coder to perform medical record reviews and coding to support risk adjustment and Medicare compliance. The role involves identifying documentation gaps, communicating with providers, and ensuring accurate ICD-10-CM coding across multiple facilities. At least 2 years in a hospital or clinic setting and CRC/ CPC certification are required. #J-18808-Ljbffr

## Certified Risk Adjustment CoderApplylocations: Hialeah, FLtime type: Full timeposted on: Posted Todayjob requisition id: JR102682**As Mount Sinai grows, so does our legacy in high-quality health care.**Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.**Culture of Caring: The Sinai Way**Our hardworking,...

Cano Health is looking for a Risk Adjustment Coder in the Town of Florida, NY. The role involves identifying and documenting claims coding information while ensuring the accuracy of diagnosis codes. Candidates should have two years of medical coding experience and relevant certifications. The ideal candidate must be proficient in Microsoft Office and possess strong organizational skills. Join a dynamic team dedicated to improving patient care in a supportive environment. #J-18808-Ljbffr

Mount Sinai Medical Center is seeking a qualified candidate with extensive coding experience to ensure accurate documentation and compliance. The role requires a minimum of five years' experience in coding and billing, along with a CPC, CCS-P, or CRC certification. This position is vital for maintaining high-quality healthcare standards while collaborating with various departments. Benefits include health insurance, retirement plans, and more. #J-18808-Ljbffr

Cano Health, LLC is seeking a Risk Adjustment Coder to join our hybrid team in New York. The coder will identify and document coding information crucial for Clinical Condition Categories and ensure diagnosis code accuracy. This role involves regular collaboration with healthcare providers, and candidates must have coding certifications and prior experience. This position emphasizes attention to detail and strong organizational skills, suitable for professionals passionate about healthcare. #J-18808-Ljbffr

Mount Sinai Medical Center of Florida, Inc. is seeking a Certified Risk Adjustment Coder to ensure accurate coding and documentation standards. The role involves reviewing medical records, providing feedback to physicians, and maintaining coding credentials. The ideal candidate will have at least five years of experience in coding and billing, with a strong knowledge of ICD-10-CM and CPT. Benefits include health insurance, paid time off, and tuition reimbursement. #J-18808-Ljbffr

Millennium Physician Group is seeking a RISK ADJUSTMENT CODING SPECIALIST to abstract and assign ICD‑10‑CM diagnosis codes and conduct audits of medical records. The role requires advanced knowledge of medical terminology and coding practices, with a strong emphasis on data analysis and technical skills. A minimum of 2 years of relevant experience is necessary, with the ability to manage workloads effectively. Candidates will be responsible for improving documentation standards and coding accuracy while maintaining communication with leadership. #J-18808-Ljbffr

As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role...

## Risk Adjustment CoderApplyremote type: Hybridlocations: Jupiter, FLtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR4147It'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 will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.**Duties & Responsibilities****Essential Duties & Responsibilities*** Review medical record information to identify all appropriate coding...

Job Summary The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations. Duties & Responsibilities Review medical record information to identify all appropriate coding based on CMS HCC categories. Prepare the medical charts and track patient information via Excel spreadsheets. Complete appropriate paperwork/documentation/system entry regarding claim/encounter information. Provide coding support, education and training related to documentation quality, level of service and diagnosis coding consistent with established coding guidelines and standards. Provide...

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. 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 other departments to address coding updates and support risk...

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Day - 08 Hour (United States of America)This is a Stanford Health Care - University Healthcare Alliance job.A Brief OverviewThe 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.LocationsStanford Health Care - University Healthcare AllianceWhat you will doRisk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing medical records to ensure accurate HCC coding and...

Job Title: HCC | Risk Adjustment Coder Location: Newark, NJ (100% Remote) Duration: 6 months (possible extension) Pay Rate: $30 - $35/hr. on W2 Schedule: Regular Business Hours. Important Details: Candidates can be located in any one of the five states: NJ, NY, PA, CT, and DE You will be required to travel for the pickup and return of equipment, and/or laptops that need servicing. Job Summary: Responsible for reviewing, auditing, coding, and analyzing medical records to ensure accurate diagnosis documentation and HCC abstraction. Supports Medicare, Medicaid, Commercial Risk Adjustment programs, and RADV audits while ensuring compliance with ICD-10 coding guidelines and risk adjustment regulations. Key Responsibilities Review medical records for coding accuracy, completeness, and compliance Abstract and validate HCC diagnoses using ICD-10, CPT, and HCPCS coding systems Support Medicare Advantage, Medicaid, Commercial, and ACA risk...

Stanford Health Care is seeking a Senior Risk Adjustment Coder in Newark, NJ, responsible for code audits and abstraction in line with regulations. This role requires collaboration with clinicians to ensure accurate coding and compliance initiatives. Applicants should have over 5 years of experience with coding guidelines, preferably in a healthcare setting. Stanford Health Care values diversity and encourages qualified applicants from all backgrounds to apply. #J-18808-Ljbffr

A healthcare technology company is seeking a Coding Associate responsible for delivering high-quality risk adjustment coding services for clients. This role requires reviewing medical records, assigning diagnosis codes, and ensuring compliance with CMS standards. Required qualifications include relevant certifications and 1-2 years of medical coding experience. The position offers a competitive salary package, comprehensive benefits, and opportunities for professional growth. This is a fully remote role based in the United States. #J-18808-Ljbffr

The Jacobson Group is seeking a remote Risk Adjustment Coding Reviewer to perform audits across Medicare, Commercial, and Medicaid lines. You will review vendor and provider coding for accuracy, analyze medical records, and ensure correct ICD-10-CM code assignment. Weekly audit reports will be submitted to leadership via templates and meetings. Requirements include 2+ years in risk adjustment coding, CMS HCC experience, CRC certification, and MS Office proficiency. #J-18808-Ljbffr

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

A consulting firm specializing in health care disputes seeks a Sr. Associate to utilize their expertise in coding, revenue cycle, and clinical operations. Responsibilities include coding diagnoses from medical records and managing small projects while ensuring compliance with regulations. Candidates should be certified in Risk Adjustment Coding (CRC) with strong analytical and communication skills. There is a competitive salary range of $85,000 to $200,000 and opportunities for hybrid work arrangements. #J-18808-Ljbffr

Job Summary Provides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials. Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately. Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff. Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment. Builds positive relationships between providers and the business by providing coding assistance as needed....

Molina Healthcare provides support for medical coding activities, ensuring ICD-10 and CPT codes are reported accurately to maintain compliance and minimize denials. It contributes to a strategy of quality, cost-effective member care. Essential duties include chart reviews, accurate coding, feedback to leadership and staff, and training provider networks on risk adjustment and coding updates. The role fosters relationships with providers and collaborates across departments to support managed care #J-18808-Ljbffr

Location Miramar, Florida Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline....

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.Summary:Responsible for auditing physician evaluation and management and procedures coding and billing to ensure they meet the official coding guidelines, medical necessity and compliance with regulatory requirements.Responsibilities:Prepare formal audit report of audit background, steps and findings to presentation to executive leadership and the Board of Commissioners.Participates in investigations and responds to questions, issues, reports and formal inquiries by federal and state agencies of possible violations or non- compliance matters raised by employees, patients, physicians and the public.Monitor and assess compliance with state and federal laws and the System's policies and procedures to identify deviations and...

Minimum to Midpoint Pay Rate: $20.50 - $27.85/ hour This is a remote position. Incumbents, who reside in Florida only, may work remotely. There may be occasional situations that require work to be performed on-site at an assigned Lee Health location. Summary 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. Professional Fee Specific: Responsible for coding Surgical Records, Evaluation & Management Encounters, ED (with E&M) and as needed Diagnostic, HCC, Retrospective Coding, Documentation Quality Assurance, and Ancillary...