252 risk adjustment coder jobs found

Incentives Physician Office | Kettering | Full-Time | First Shift Overview Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God's love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care. Responsibilities & Requirements This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the...

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 page is loaded## Risk Adjustment Coderremote type: Hybridlocations: Jupiter, FLtime type: Full timeposted on: Posted Todayjob requisition id: JR4078It'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...

Risk Adjustment Coder Join VillageCare as a Full Time Risk Adjustment Coder and embrace the opportunity to work remotely while making a significant impact in the Health Care sector. This role offers the flexibility of a work-from-home environment, allowing you to balance your professional and personal commitments without the daily commute. You'll be part of a dynamic team that thrives on innovation, problem-solving, and a customer-centric approach, all while contributing to the excellence and integrity that VillageCare stands for. With a competitive salary up to $77,506.87 - $87,195.23, this is not just a job but a chance to build your career in a forward-thinking organization dedicated to healthcare improvement. As a team member you'll be able to enjoy benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional...

We are looking for 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 procedure...

We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Risk Adjustment Coder works in a collaborative effort directly with physicians and their office staff and other support departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major focus of the position is to collect and review documents to support the organization's quality and risk adjustment initiatives, which results in improving quality of care. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Ensures compliance with all applicable Federal, State and/or County laws and regulations related to...

Senior Director, Health Care 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...

University HealthCare Alliance (dba Stanford Medicine Partners) is the medical foundation of Stanford Health Care and Stanford Medicine. Stanford Medicine Partners was born out of the aspiration for Stanford Medicine and local, leading providers to partner together to bring high-quality care to patients within surrounding communities. Together, we are committed to delivering outstanding, leading-edge care to our patients. How We Work With Stanford Health Care Anchored by Stanford Health Care and the Stanford School of Medicine, Stanford Medicine Partners is dedicated to providing the highest standards of clinical excellence in order to ensure access for Bay Area patients to leading providers, while contributing to Stanford University’s well-respected Stanford Hospital and Clinics’ transformation into a broader and more integrated regional health system. Together, SMP and Stanford are pioneering new ways to practice medicine across multiple locations, using Stanford’s advanced...

Astrana Health Management is hiring a Risk Adjustment Coding Specialist II in Maryland. This full-time role involves conducting high-volume chart reviews to ensure coding accuracy for Medicare and ACA requirements. The ideal candidate has 3-5 years of risk adjustment experience, along with CPC or CRC certifications. Strong communication and Excel skills are essential. The position follows a hybrid work structure, requiring occasional travel to provider sites in Maryland. The compensation ranges from $70,000 to $85,000 per year. #J-18808-Ljbffr

Astrana Health Management in Houston, Texas seeks a Risk Adjustment Coding Specialist II to support risk adjustment efforts through high-volume coding reviews. The role requires 3-5 years of coding experience, strong communication skills, and AAPC or AHIMA certification. This is a full-time position with a hybrid structure, requiring monthly travel to Beaumont. Compensation is between $70,000 and $85,000 per year, based on location and experience. #J-18808-Ljbffr

Senior Risk Adjustment Coder Drive accuracy. Influence outcomes. Protect revenue. We are seeking a highly experienced Senior Risk Adjustment Coder to play a critical role in risk adjustment accuracy, audit readiness, provider education, and clinical documentation excellence. Location: Newark, CA (Candidates must currently reside within approximately 45–65 miles of the Newark area due to onsite operational needs.) Employment Type: Full-Time (Direct Hire) Salary Range: $91,000 – $119,000 annually, based on experience, skills, and internal equity About the Role: We are seeking a senior-level Risk Adjustment professional to support a leading healthcare organization focused on accurate HCC capture, audit readiness, documentation integrity, and provider engagement. This role is highly operational and collaborative in nature and is not a traditional production-only coding position. The ideal candidate will bring strong expertise across Risk Adjustment workflows,...

Senior Risk Adjustment Coder Drive accuracy. Influence outcomes. Protect revenue. We are seeking a highly experienced Senior Risk Adjustment Coder to play a critical role in risk adjustment accuracy, audit readiness, provider education, and clinical documentation excellence. Location: Newark, CA (Candidates must currently reside within approximately 45–65 miles of the Newark area due to onsite operational needs.) Employment Type: Full-Time (Direct Hire) Salary Range: $91,000 – $119,000 annually, based on experience, skills, and internal equity About the Role: We are seeking a senior-level Risk Adjustment professional to support a leading healthcare organization focused on accurate HCC capture, audit readiness, documentation integrity, and provider engagement. This role is highly operational and collaborative in nature and is not a traditional production-only coding position. The ideal candidate will bring strong expertise across Risk Adjustment workflows,...

A healthcare organization in Kettering, Ohio, is seeking a Certified Risk Adjustment Coder. This full-time role involves reviewing ambulatory records and coding outpatient patient records to ensure accurate risk adjustment. Candidates must hold an Associate or Bachelor’s degree in Health Information Management and have at least one year of coding experience. Certification as a Certified Risk Adjustment Coder (CRC) is required. Strong communication skills and teamwork abilities are essential for successful collaboration with providers and clinical documentation specialists. #J-18808-Ljbffr

Job Details Physician Office | Kettering | Full-Time | First Shift Responsibilities & Requirements Job Overview: The Certified Risk Adjustment Coder is responsible for reviewing the ambulatory records for the appropriate risk adjustment components. The Risk Adjustment Coder will identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes. The Risk Adjustment Coder will leverage the MEAT (Monitor, Evaluate, Assess, Treat) criteria for accurate documentation by providers. When appropriate, the Risk Adjustment Coder will query providers to clarify the HCC codes placed, inquire on additional documentation to support the HCC code placed, or discuss overall opportunities within the record. The Risk Adjustment Coder will supplement the educational offerings of the MSO by providing right-time feedback to providers when documenting or coding the risk adjustment on patient records. The Risk Adjustment Coder...

A healthcare company seeks a Risk Adjustment Coding Specialist II in Orange, CA. The role involves reviewing medical records, educating providers, and performing coding audits. Candidates must have strong coding skills and certifications, along with 3-5 years of risk adjustment experience. This position requires up to 75% travel to provider offices and follows a hybrid work structure, allowing flexibility in work location. Competitive pay ranges from $70,000 to $85,000 per year. #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...

A health care advisory firm is seeking a Sr. Associate to analyze medical records and ensure compliance with coding standards. The ideal candidate will be certified in Risk Adjustment Coding and have at least five years of experience in HCC/Risk Adjustment methodologies. Strong communication skills and proficiency in Excel are essential. This role offers a hybrid work environment. Salary range is between $85,000 to $200,000 based on qualifications and experience. #J-18808-Ljbffr

St. Joseph's Health is looking for a full-time Risk Adjustment Coding Specialist to review clinical documentation and coding while adhering to CMS guidelines. This role supports HCC coding for risk adjustment, ensuring accuracy with ICD-10-CM codes in a remote environment. Ideal candidates will have excellent communication skills, a CRC or CPC certification (to be obtained within a year), and the ability to multitask effectively. Compensation ranges from $24.60 to $32.80 per hour, based on location and experience. #J-18808-Ljbffr

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...

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 Overview** 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****Education Qualifications*** High school diploma or GED equivalent.* Bachelor's Degree preferred.**Experience Qualifications*** 5+ years of work experience in a risk...

A healthcare organization is seeking a Senior Risk Adjustment Coder to perform code audits and compliance tasks. The ideal candidate should have over 5 years of experience and a solid understanding of coding guidelines. This role requires effective communication and problem-solving abilities to ensure accurate HCC coding while collaborating across departments. Competitive hourly salary range of $44.13 - $57.36 is offered. #J-18808-Ljbffr

A leading consulting firm in Washington, DC seeks a Sr. Associate specialized in healthcare coding and compliance. The role involves analyzing patient records, ensuring coding guidelines adherence, and managing complex investigations. Candidates must have a CRC certification and strong communication skills, with the ability to work independently. The position offers a competitive salary range between $85,000 and $200,000, depending on experience, and focuses on maintaining high quality in a fast-paced environment. #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...

A leading healthcare company is seeking a Risk Adjustment Coding Specialist in Maryland. This full-time position requires a Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) with 3-5 years of experience. The specialist will review and audit provider documentation and coding for compliance in Medicare Advantage programs. The role follows a hybrid work structure with both remote and onsite responsibilities. A strong command of Excel and healthcare coding software is essential for this position. #J-18808-Ljbffr