Risk adjustment coder specialist jobs

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Layton, FL, USA

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Toledo, OH, USA

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Raleigh, NC, USA

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical New York, NY, USA

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

GM

Medical Risk Adjustment Specialist (Coder)

Greenbrook Medical Tampa, FL, USA

Job Description Job Description Please only submit an application if you live in one of these states: FL, VA, TX, NY, MO About Us At Greenbrook Medical, we believe seniors deserve more from the healthcare system—more time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volume—so we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven,...

SM

Full Time

Senior Risk Adjustment Coder (CPC, CRC, and CCDS required) - Remote/CA Resident

Stanford Medicine Partners Remote (CA, USA)

Senior Risk Adjustment Coder (CPC, CRC, and CCDS required) Stanford Medicine Partners Newark, CA (Remote/CA Resident) Stanford Medicine Partners (SMP) is looking for an amazing Senior Risk Adjustment Coder to join our rapidly growing team! SMP prides itself in offering exceptional service and patient care. Stanford Medicine Partners with Stanford Health Care to provide individualized and convenient care with access to Stanford specialists and technology. Join our team and start making a difference today! 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. What you will do Risk Adjustment...

Contract

Mid-Level Medical Coder

PAC GROUP LLC Remote

Location: Full-Time Remote Clearance: No Secret Clearance Required Starting Salary: $37.00/Hour Note: All positions require U.S. Citizenship. Applicants must be U.S. citizens — visa holders and green card holders are not eligible. “Candidates must hold valid credentials from either AAPC or AHIMA to be eligible to apply.” Please indicate the position(s) you’re applying for. Include your full mailing address (for equipment shipment), desired start date, and AAPC and/or AHIMA certification number(s) (with expiration date). If you’ve already applied through our website, there’s no need to reapply for this position! Assessment Protocol The assessment is strictly timed and must be completed within 1 hour. Once the link is opened, the timer is automatically activated. The assessment cannot be paused, reopened, or restarted. Only the initial attempt will be accepted for scoring. Candidates are provided with a 24-hour window to complete...

Full Time

Director, Compliance, Medical Coding (Remote)

Kaiser Permanente Remote (Washington, DC, USA)

When you join Kaiser Permanente, you’ll be part of an organization dedicated to total health. At every level and in every department, it’s what we stand for. By using your innovation and your creativity, you can play a role in the health of communities across town and around the country by serving 12.5 million of our members. No matter your background, your ideas can help drive a health care pioneer. You can play a role in the future of health. Director, Compliance, Medical Coding (Remote) Oakland, California Full-Time, Salary Range: $192,200 – $248,710/Year ******This is a 100% remote position, and you may be based in any of the following Kaiser Permanente locations: CA, GA, CO, OR, WA, VA, MD, or Washington, D.C. In addition to the responsibilities listed below, the position is also responsible for serving as a Risk Adjustment compliance subject matter expert related to coding functions, overseeing audit activity related to coding...

Part Time Contract

Remote Medical Coder - Surgical, Anesthesiology & HCC Specialties | patients.app | Part-Time/Supplemental Income Opportunity

patients.app Remote

patients.app - a leading AI research team in health care Remote Medical Coder - Surgical, Anesthesiology & HCC Specialties Part-Time/Supplemental Income Opportunity Patients.app is a team of engineering researchers, MDs, and public health experts transforming healthcare delivery through advanced technology. We combine information from EMRs, HIEs, faxes, and PDFs to build complete patient pictures across national sites, using AI to create specialty-focused checklists, reports, and clinical documentation that supports treatment decisions. Our platform is currently deployed with leading health systems and maintains SOC 2 certification with the highest standards for data security and HIPAA compliance. We're seeking an experienced medical coder with expertise in surgical, anesthesiology, and HCC coding to join our remote team on a flexible, hourly basis. This position is ideal for certified coders looking to supplement their primary income. You'll play a crucial role in...

Full Time

Risk Adjustment Coding Specialist I or II

Astrana Health, Inc. Remote (CA, USA)

Key Responsibilities: Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC) Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation Prepare and/or perform auditing...

VH

VMG Risk Adjustment Coder - CRC within 6 months! (Remote)

Virtua Health Dayton, OH, USA

Virtua Health Coding Specialist Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). CRCs review provider documentation and communicates coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models. Position Responsibilities: Evaluates and analyzes medical records for proper documentation. Identifies and communicates coding deficiencies to clinicians in order to improve documentation for accurate risk adjustment coding. Provides on-going training and education to the clinicians and physicians during 1:1, physician group, performance improvement and ad hoc meetings. Manages and trends data collection for HCC and other...

UH

Compliance Auditor, Billing and Coding Compliance

UT Health San Antonio San Antonio, TX, USA

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

TJ

HCC Coder - DUPLICATE DO NOT TRACK

The Judge Group The Colony, TX, USA

Judge Healthcare is actively seeking DIRECT HIRE REMOTE HCC CODERS. Job Title: Risk Adjustment Coding Specialist Location: Fully Remote Job Type: Full-Time (Monday-Friday) Experience Required: Minimum 6 months of HCC Coding experience At least 18 months of total coding experience Certifications Required: Must be certified through either AAPC or AHIMA (Apprenticeship designations are not accepted) Acceptable credentials: CPC, CRC, COC, RHIA, RHIT, CCS, or CCS-P Job Summary: The Judge Group is seeking a dedicated Risk Adjustment Coding Specialist to join our team. This full-time, remote position involves reviewing and abstracting ICD-10 codes that map to HCCs, RxHCCs, and ESRD models. Adherence to Medicare and ICD-10-CM guidelines, along with client-specific requirements, is essential. Essential Duties and Responsibilities: Review and analyze patient medical records for project-specific guideline compliance Accurately assign codes...

DJ

HCC Coding Auditor Senior - Health Plan Admin

Direct Jobs Irving, TX, USA

Description Summary: The HCC Coding Auditor Senior will perform code audits and abstraction using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and 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, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). This is an onsite position with a remote option. Responsibilities: Perform Medical Record reviews and audits based on organizational priorities. These can include both prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment....

UH

Medical Coding Specialist II - Fiscal Coding and Denials

UW Health Middleton, WI, USA

Medical Coding Specialist II This is a full-time, 1.0 FTE position that is 100% remote. Applicants hired into this position can work remotely 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. Join the #1 hospital in Wisconsin! We are seeking a Medical Coding Specialist II: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements...

VH

VMG Risk Adjustment Coder - CRC within 6 months! (Remote)

Virtua Health Salida, CA, USA

Virtua Health Coding Specialist Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). CRCs review provider documentation and communicates coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models. Position Responsibilities: Evaluates and analyzes medical records for proper documentation. Identifies and communicates coding deficiencies to clinicians in order to improve documentation for accurate risk adjustment coding. Provides on-going training and education to the clinicians and physicians during 1:1, physician group, performance improvement and ad hoc meetings. Manages and trends data collection for HCC and other...

PH

Health Information Management Inpatient Coding Auditor Sr. FT, Days, - Remote

Prisma Health Columbia, SC, USA

Overview Inspire health. Serve with compassion. Be the difference. Job Summary: Responsible for leading coding teams, coder training, work queue management, performing prebill and second-level coding reviews utilizing auditing software and documenting findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employs critical thinking to alert coding leadership to trends identified in reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts review...

IR

Professional Coder I

Integrated Resources Newark, NJ, USA

Manager Notes 11/13/25- • Job description is up to date. prefer Client experience, if possible, but not a requirement. • Position is fully remote • Potential temp-perm so must be local to Client locations. Once an employee, some onsite requirements Job Description: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: • Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC...

Ax

Professional Coder I

Axelon Newark, NJ, USA

Job Title: Professional Coder I Position: Fully Remote Note: Potential temp-perm so must be local to client location Description Summary: Accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. Supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify,...

VH

VMG Risk Adjustment Coder - CRC within 6 months! (Remote)

Virtua Health Brookhaven, NY, USA

Virtua Health Coding Specialist Evaluates and analyzes medical records for proper documentation and the correct diagnosis (ICD-10-CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., hierarchical condition categories (HCCs), Chronic Illness & Disability Payment System (CDPS), and U.S. Department of Health and Human Services (HHS) risk adjustment). CRCs review provider documentation and communicates coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models. Position Responsibilities: Evaluates and analyzes medical records for proper documentation. Identifies and communicates coding deficiencies to clinicians in order to improve documentation for accurate risk adjustment coding. Provides on-going training and education to the clinicians and physicians during 1:1, physician group, performance improvement and ad hoc meetings. Manages and trends data collection for HCC and other...

HM

Physician Billing (PB) Coding Auditor and Educator

Hackensack Meridian Health Teterboro, NJ, USA

Physician Billing (PB) Coding Auditor And Educator Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network. A day in the life of an Physician Billing (PB) Coding Auditor and...

AI

Inpatient Facility Medical Coder

American IT Staff Seattle, WA, USA

Company Description Job Description To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional...

PH

Health Information Management Inpatient Coder, FT, Days, - Remote

Prisma Health Columbia, SC, USA

Join to apply for the Health Information Management Inpatient Coder, FT, Days, - Remote role at Prisma Health 2 days ago Be among the first 25 applicants Join to apply for the Health Information Management Inpatient Coder, FT, Days, - Remote role at Prisma Health Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the organization billing/abstracting systems and to complete the coding function through established best practice processes and professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired...

PH

Health Information Management Inpatient Coder, FT, Days, - Remote

Prisma Health Columbia, SC, USA

Job Summary Inspire health. Serve with compassion. Be the difference. Codes medical information into the organization billing/abstracting systems and to complete the coding function through established best practice processes and professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related Groups (DRG) assignment. Abstracts and assigns and verifies codes for Major Complications and Comorbidities/Complications and Comorbidities (MCC/CCs), Hospital-Acquired Condition/Patient Safety Indicator (HAC/PSI) and Quality Indicators capture as appropriate through documentation validation. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health...

49 risk adjustment coder specialist jobs found