99 risk adjustment coder specialist jobs found

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...

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...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. 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 ourselves-one 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...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. 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 ourselves-one 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...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. 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 ourselves-one 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...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. 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 ourselves-one 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...

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 team meetings and company events. Pay Transparency The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities Responsible for daily operations pertaining to Risk...

A healthcare provider in Illinois is seeking an Ambulatory Risk Adjustment Coding Specialist I. This role involves identifying HCC codes in outpatient visits, verifying documentation, and maintaining accurate coding standards. The ideal candidate will have a high school diploma, work experience in healthcare, and knowledge of ICD-10-CM codes. Benefits include medical options, tuition reimbursement, and a professional growth pathway. This position is full-time, located in Skokie, IL. #J-18808-Ljbffr

Job Description Job Description Please only submit an application if you live in one of these states: FL, VA, TX, NY, NJ, 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,...

A healthcare provider organization is seeking a Risk Adjustment Coding & Documentation Specialist to oversee compliance activities related to Medicare and Medicaid. This role includes conducting medical record reviews, supporting risk adjustment data validations, and ensuring proper coding standards are met. Candidates should possess an Associate's degree and relevant coding certifications, along with medical coding experience. The position offers benefits like medical plans, 401k matching, and tuition assistance, within a hybrid work model. #J-18808-Ljbffr

A leading healthcare provider in California is seeking a Coder 1 for Risk Adjustment. This role involves reviewing clinical documentation for accuracy in support of Hierarchical Condition Category diagnoses and communicating with providers to ensure quality documentation. The ideal candidate requires a Bachelor's degree, certification as a Risk Adjustment Coder, and at least two years of clinical experience. Strong skills in medical terminology and effective communication are essential for success in this position. #J-18808-Ljbffr

A leading health organization seeks a skilled candidate for HCC coding roles in Boyce Lawn, South Carolina. You will lead prospective and retrospective reviews to identify and confirm coding opportunities with providers. The role requires five years of professional coding experience along with CPC and CRC certifications. The ideal candidate will excel in communication and proficiency in healthcare coding software. Join us to inspire health and serve with compassion. #J-18808-Ljbffr

A healthcare organization is seeking a full-time Certified Medical Coder focusing on risk adjustment for its clinically integrated network. This remote position requires candidates to be located in the Knoxville, TN region. Responsibilities include performing detailed clinical documentation reviews and coding procedures using ICD-10-CM, CPT, HCPCS, and modifiers. Candidates should have a CPC or RHIT certification and at least two years of medical coding experience. A comprehensive benefits package is available including PTO and 401k with company match. #J-18808-Ljbffr

A healthcare provider in South Carolina is seeking an experienced healthcare coder to conduct reviews for Hierarchical Condition Categories (HCC) coding. Responsibilities include conducting prospective and retrospective chart reviews, communicating with healthcare providers on documentation, and utilizing software tools for data capture. The ideal candidate will have a high school diploma, relevant coding certifications, and five years of professional coding experience. This position emphasizes knowledge of coding practices and contributes to improving healthcare outcomes. #J-18808-Ljbffr

Summary: Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. 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. Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts...

Internal Reference Number: R1049005 Summary We are currently hiring for a Medical Coding Specialist to join BlueCross BlueShield of South Carolina. In this role as a Medical Coding Specialist, you will review medical documentation to perform a variety of coding validations for multiple lines of business under Medicare/TRICARE to determine accuracy of billing and payment, reassign and sequence diagnostic and procedural codes using universally recognized coding system as appropriate, and compile and analyze statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE payments.Description Location This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm EST and will be hybrid in Columbia, SC. What You'll Do: Determines methodology to identify cases for DRG, HIPPS, HCPCS, RUG, and APC validation. Conducts targeted coding, documentation reviews, and validation...

Medical Coding Specialist (HCC / Risk Adjustment) — Remote (Houston only) Pay Rate: $30.00/hour Schedule: Monday–Friday, 8:00 AM – 4:30 PM (CST) Location: Remote (must attend monthly onsite meetings in The Woodlands, TX unless out of region) Position Summary We are seeking an experienced Medical Coding Specialist with HCC/Risk Adjustment experience to support outpatient provider documentation and accurate condition capture. This role is responsible for reviewing medical records, assigning appropriate ICD-10 and CPT codes, identifying eligible HCC conditions, and supporting accurate problem lists in the EHR. The ideal candidate is detail-oriented, productive, and comfortable working independently in a remote environment while collaborating closely with clinical teams. Key Responsibilities Review outpatient medical records and abstract relevant clinical and demographic data. Assign accurate ICD-10 and CPT codes in accordance with current coding guidelines. Identify and validate...

Title - Coding Auditor Location - Clackamas, OR Job Type - Permanent Job Summary: 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),...

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 coding...

Risk Adjustment & Coding Manager We are seeking a detail-driven and collaborative Risk Adjustment & Coding Manager to support our Senior CommUnity Care (PACE) programs. This role works closely with SCC Medical Directors and providers to ensure accurate capture and reporting of participant acuity through compliant diagnostic coding. The position plays a critical role in maintaining CMS compliance while directly supporting the financial integrity and performance of our PACE programs. About the Job Works in concert with Senior CommUnity Care (SCC) Medical Directors and providers to ensure an accurate representation of participant acuity is captured through diagnostic coding and reported to CMS. Assists in the development and implementation of systems and processes to ensure the integrity of diagnostic coding and reporting, directly impacting the financial performance and compliance of the PACE programs. Acts as a liaison between PACE providers and contracted providers to...

Job Description Job Description Lamoille Health Partners is looking for a Certified Medical Coder to accurately translate diagnostic and procedural information from patient medical records into standardized codes. The Medical Coder plays a crucial role in ensuring accurate billing and reimbursement, as well as contributing to valuable healthcare data collection. ESSENTIAL FUNCTIONS: Review and analyze patient medical records, including physician notes, operative reports, laboratory and radiology results, and discharge summaries, to identify pertinent diagnoses and procedures. Accurately assign ICD-10-CM, CPT, and HCPCS codes according to official coding guidelines and regulations. Ensure proper sequencing of codes to optimize reimbursement and meet payer requirements. Abstract relevant information from medical records, including patient demographics, diagnoses, procedures, and dates of service. Identify and resolve coding discrepancies, errors, and omissions by...