823 risk adjustment coder jobs found

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II for Orange County. This role focuses on chart reviews to identify coding gaps and drive accuracy for Medicare Advantage, ACA, and commercial plans. You will educate providers, track KPIs like HCC recapture and AWVs, and work up to 75% travel to provider offices in Orange County. AAPC/AHIMA certification and 3+ years of risk adjustment experience are preferred. #J-18808-Ljbffr

Suvida Healthcare is seeking a Risk Adjustment Coder to enhance documentation and coding accuracy in patient records. This role involves reviewing medical documents, providing feedback, and educating healthcare providers on coding standards to deliver high-quality care for our seniors. Ideal candidates will have a strong background in ICD-10 coding, possess excellent communication skills, and work well in a collaborative environment. Join us in making a meaningful impact within a diverse and dedicated team. #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...

Humana is looking for a skilled medical coder to review records, map conditions to HCCs, and apply ICD-10 codes. You will follow regulations, work on special projects, and often communicate with providers by phone. Overtime may be required to meet deadlines and ensure timely tasks completion. Training is 3 weeks remote, Mon–Fri 8am–4:30pm ET. After training, you will work 40 hours weekly within your own time zone, with occasional overtime as needed. #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...

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...

GeBBS Healthcare Solutions is looking for a flexible CMS HCC/Risk Validation Auditor for a seasonal project in East Haven, Connecticut. The role offers full-time opportunities at either 30 or 40 hours weekly, with flexible hours, including nights and weekends. The ideal candidate will have at least 5 years of verifiable risk adjustment coding experience and required active certification with AAPC or AHIMA. Responsibilities include reviewing member and claim data, confirming diagnoses, and adding valid risk-adjusting diagnoses. #J-18808-Ljbffr

Job Description Job Description Description: This is a flexible CMS HCC/Risk Validation Audit role for a seasonal project. Other opportunities for continued work may be available at the conclusion of the project. Full time opportunities are available at either 30 or 40 hours weekly. Flexible work hours - nights and weekends are acceptable. Coders will review member and claim data validation aspects, which include: Member name, Member DOB, Gender, Dates of service, claim type, and provider signature Coders will be presented with all risk-adjusting diagnoses billed on a claim for a particular date of service or inpatient stay Must be able to identify acceptable provider specialty Coder must have knowledge of ICD-10-CM IP and OP coding Coders will confirm or not confirm each diagnosis Coders will add risk-adjusting diagnoses that are valid but not reported Requirements: Active certification through AAPC or AHIMA is required Minimum 5 years verifiable risk...

Description This is a flexible CMS HCC/Risk Validation Audit role for a seasonal project. Other opportunities for continued work may be available at the conclusion of the project. Full time opportunities are available at either 30 or 40 hours weekly. Flexible work hours - nights and weekends are acceptable. Responsibilities Coders will review member and claim data validation aspects, which include: Member name, Member DOB, Gender, Dates of service, claim type, and provider signature Coders will be presented with all risk-adjusting diagnoses billed on a claim for a particular date of service or inpatient stay Must be able to identify acceptable provider specialty Coder must have knowledge of ICD-10-CM IP and OP coding Coders will confirm or not confirm each diagnosis Coders will add risk-adjusting diagnoses that are valid but not reported Requirements Active certification through AAPC or AHIMA is required Minimum 5 years verifiable risk adjustment coding experience post...

Hybrid | Des Moines, IA (Onsite Tues–Thurs, 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 Tuesday–Thursday 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 and support compliance with CMS guidelines. Key...

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire. The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms. Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package. #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...

Overview Ankura is a team of excellence founded on innovation and growth. 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 and most...

## 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

Strivehealth seeks a Coder for Risk Adjustment Coding in Denver, Colorado. This hybrid remote role supports operations by reviewing coding for accuracy, ensuring compliance with regulations, and providing vital feedback to enhance care outcomes. Ideal candidates will hold a CRC or CPC certification and possess over 5 years of relevant experience. Benefits include comprehensive healthcare, a performance-based bonus, and professional development opportunities. #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

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

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...

Humana is seeking a Medical Coder / Coding Educator 2 who will identify opportunities to improve provider documentation and create an education plan tailored to each assigned provider. The role reports to the Manager, Medicare Risk Adjustment and emphasizes data-driven coaching. Responsibilities include scheduling sessions, analyzing coding quality trends, and delivering on-site education while collaborating with other provider-facing roles. #J-18808-Ljbffr

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...

Humana is seeking a detail‑oriented coder to review medical records and map diagnoses to HCCs using ICD‑10 codes. This role requires certification through AAPC or AHIMA and comfort working in a production‑driven environment. Training is virtual for 3 weeks, then 40 hours per week with potential overtime. Strong proficiency in Microsoft Word and Excel is preferred, as is experience with risk adjustment and HCC coding. #J-18808-Ljbffr