96 risk adjustment coding auditor educator jobs found

A healthcare provider organization in Wisconsin seeks a Senior Coding Auditor. This role requires performing code audits, ensuring compliance with coding guidelines, and educating providers on coding practices. Candidates should have at least 5 years of coding experience, current certification, and expertise in risk adjustment programs. A comprehensive benefits package and a bonus opportunity are also offered. Join a team committed to excellence in healthcare coding. #J-18808-Ljbffr

A leading healthcare organization in Utah is looking for a Senior Coding Auditor to perform code audits and educate stakeholders on coding practices. Candidates should have a minimum of 5 years' experience and a current coding certification. The position involves maintaining compliance with coding guidelines and leading audit processes within the finance department. A competitive salary range of $81,000 to $99,000 along with a bonus eligibility and a rich benefits package is offered. #J-18808-Ljbffr

A healthcare organization is seeking a Senior Coding Auditor to lead coding audits, ensure compliance with regulations, and educate internal stakeholders. The ideal candidate will have over 5 years of experience as a certified coder, with strong knowledge of diagnosis coding conventions. The role requires maintaining active coding certification and engaging in continuous education on coding topics. Benefits include competitive pay and a comprehensive rewards program, along with opportunities for professional development. #J-18808-Ljbffr

A leading healthcare facility in Renton, WA seeks a Risk Adjustment Auditor and Physician Educator to develop processes for medical record audits and deliver coding education. This role requires a Bachelor's degree in health sciences and certifications like CPC and CRC. The ideal candidate will have at least 3 years' experience in coding and training, a deep understanding of chronic disease management, and exceptional communication skills. Join our committed team to enhance healthcare quality and compliance. #J-18808-Ljbffr

Job Title: Risk Adjustment Auditor and Physician Educator (4088) Req: 2026-0181 Location: VMC Main Campus Department: Health Information Mgmt Shift: Days Type: Full Time FTE: 1 Hours: 8:00-4:30 City State: Renton, WA Category: Professional Salary Range: Min $86,267 - Max $129,401/annual DOE Job Description The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization. Job Overview The Risk Adjustment Auditor and Physician Educator is responsible for developing the process and reporting for performing annual, period, and other quality assurance reviews of medical record documentation and coding to ensure appropriate capture of Hierarchical Condition Categories (HCC) conditions. This position utilizes expertise and national coding guidelines as...

Job Description Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. BENEFITS for Full and Part-time employees who work 30 or more hours per week: We pay 100% of the MEDICAL monthly premiums for Employee Only coverage. We pay...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Coding Compliance Auditor US Heart and Vascular is in need of a remote coding compliance auditor to join our team. The coding compliance auditor performs internal medical record audits and prepares compliance auditing reports, subsequent educational materials and training as directed by the compliance and privacy department. Audits include regular compliance medical record audits or focused review projects for ongoing review of coding and documentation for cardiovascular specialties to support compliance with coding and documentation rules and regulations. Responsibilities include performing coding audits reviewing for compliance and accuracy with CPT, ICD-10, HCPCS and corporate coding policy and following up for timely completion within designated time period. Maintains excellent documentation of all reviews, methodologies employed, results, corrective actions implemented, and monitoring. Assists in focused review projects including data analysis, reporting, and corrective...

Title: Coding Auditor, Facility Work Type: Full-Time Location: Clackamas, OR R emote Job After Completing Satisfactory Training At The Job Site MUST-HAVES : Basic Qualifications: Experience Minimum two (2) years experience in a directly related coding field Education A High School Diploma or General Education Development (GED) is required. License, Certification, Registration The candidate must have 1 from the following list: Registered Health Information Technician Certificate Certified Coding Specialist Registered Health Information Administrator Certificate Additional Requirements: Previous experience with EMR patient documentation systems with intermediate knowledge and skill in the use of a computer. Advanced knowledge of disease processes, diagnostic and surgical procedures, ICD-10-CM, ICD-10-PCS, HCPCS/CPT classification systems, and health information/medical record department responsibilities with knowledge of government regulations and areas of scrutiny...

We are looking for experienced 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...

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address:...

Our Promise To You Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Job Description Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding...

Medical Coder Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing certified medical coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: Cardiology Urology Dermatology General Surgery Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review Accurately assign ICD-10-CM, CPT, and HCPCS Level...

Overview Job Number: 178709, Job Title: Risk Adjustment Coder II, Salary: $27.69 - $34.62 Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare...

Risk Adjustment Nurse/Coder AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA) in Doral, FL! Full-time permanent position (40 hours) Standard working hours: 8am to 4:30pm EST, M-F This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary The Risk Adjustment Clinical Coder/Nurse performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories...

Health Information Management (HIM) Coder Location: Miramar, Florida 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 Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance. Responsibilities For hospital encounters, routes to billing charge entry errors and/ or account edits preventing completion of coding and/or billing. Makes appropriate coding corrections when advised and follows procedure to notify billing. Reviews chargemaster generated CPT/HCPCS codes, when errors are found Coding Management is notified to alert Charge Management to educate department making errors. Makes appropriate coding corrections when...

Job Description Job Description Remote Medical Coder Location: remote, Florida Compensation: $21-26/hr., commensurate with experience and qualifications Our Story : Physician Care Centers (PCC) is a growing healthcare MSO with 70+ value-based primary care clinics serving patients across Florida, Texas, Georgia, South Carolina, and Nevada. With a team of 500+ professionals, we’re committed to delivering exceptional care and improving patient outcomes. The Role: We’re seeking a Medical Coder to ensure accurate, compliant coding that supports revenue integrity and risk adjustment performance. Under the supervision of the Revenue Cycle Manager, you’ll review provider encounters, ensure accurate HCC capture, collaborate with clinical teams, and support documentation improvement. What You’ll Do: Review and accurately code all provider encounters (office visits, procedures, preventive care, chronic condition management). Ensure complete and compliant...

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment coding and...

A leading medical center in Florida seeks a Risk Adjustment Coder to perform coding audits and ensure accuracy in health records. Candidates should have 10+ years in coding, strong knowledge in coding guidelines, and relevant certifications. This position emphasizes teamwork to improve patient care and data quality through education and compliance initiatives. Competitive pay starting at $25.23 per hour with benefits included. #J-18808-Ljbffr

Join to apply for the Compliance Auditor Analyst role at Upstate Medical University 5 months ago Be among the first 25 applicants Join to apply for the Compliance Auditor Analyst role at Upstate Medical University Get AI-powered advice on this job and more exclusive features. Job Summary Position Summary: Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines and professional coding and billing audits. Duties/Responsibilities Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding, and billing guidelines. Interpretation of coding, billing, and regulatory standards. Preparation and completion of audit reports including recommendations, education and corrective action. Knowledge, Skills and Abilities: Strong...

Join to apply for the Health Information Management Inpatient Coding Auditor Sr. FT, Days, - Remote role at Prisma Health . 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 documents 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. Employ critical thinking skills to alert coding leadership to any trends identified in their 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...

Business, Managerial & Finance Properly codes and/or audits professional services for inpatient and/or professional and hospital outpatient technical services for multiple specialty areas to ensure accuracy and optimal reimbursement from all third-party payers. Minimum Qualifications: Three years of multi-specialty coding experience. Proficient in coding Professional services, and/or Outpatient professional and hospital technical services. Experience with communicating, training, and educating providers in proficiency. Preferred Qualifications: Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations. Required Licenses, Registrations, or Certifications: CCA Certified Coding Associate (AHIMA) or CCS Certified Coding Specialist (AHIMA) or CCS-P Certified Coding Specialist Physician Based (AHIMA) or RHIA Registered Health Information Administrator (AHIMA) or RHIT Registered Health...

Location: Miramar, Florida 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: 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...

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...