266 risk adjustment medical coder jobs found

Advantmed is seeking experienced Medical Coders with a strong background in Risk Adjustment and HCC coding. The ideal candidate will hold CPC or CCS certification and work remotely from the US, supporting our healthcare organization with accurate, compliant coding. Responsibilities include reviewing records for Risk Adjustment, ensuring ICD-10-CM and CMS-HCC guidelines, maintaining data integrity, resolving documentation gaps, and supporting audits. #J-18808-Ljbffr

University Health Network is seeking a full-time Certified Medical Coder to focus on risk adjustment for the clinically integrated network associated with The University of Tennessee Medical Center and University Physicians’ Association. The position requires normal business hours Monday-Friday and is remote with occasional on-site meetings; candidate must be located in the Knoxville, TN region. You will perform detailed documentation reviews, assign ICD-10-CM, CPT, HCPCS codes and modifiers for #J-18808-Ljbffr

Medical Risk Adjustment Coder The Medical Risk Adjustment Coder supports the physician practices and the Care Coordination Department with Coding Improvement activities using various clinical data systems. Responsibilities include collaborating with internal and external clients to streamline and optimize accurate diagnosis code capture, conducting clinical chart and patient billing audits, adhering to coding rules and CMS guidelines, assisting with HEDIS chart reviews, performing analysis and focused chart reviews, facilitating coding and documentation improvement educational materials, and providing support in the Care Coordination Department. The role also involves performing data validation and integrity functions, monitoring quality, cost, and efficiency, and maintaining compliance with Orlando Health policies. Qualifications include a high school diploma or equivalent, one of the following certifications: Certified Professional Coder (CPC) or Certified Risk Adjustment...

Risk Adjustment CoderPorter 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. 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 OverviewWe are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health assessments. The ideal candidate will have a strong understanding of CMS risk adjustment and quality initiatives, exceptional attention to...

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...

Humana seeks a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and to create education plans tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. The role involves arranging educational sessions, analyzing coding data with Excel/Power BI, and presenting findings to leadership. Eligible for remote work with travel up to 5% to provider offices. #J-18808-Ljbffr

A healthcare organization in California is seeking a Medical Coder to perform chart reviews, coding audits, and provide training on ICD-10 codes. The ideal candidate will have an AA or AS degree, relevant coding credentials, and two years of healthcare experience. Responsibilities include coding audits, maintaining knowledge of coding guidelines, and assisting with billing inquiries. This role offers competitive benefits including free medical, dental, and vision insurance. #J-18808-Ljbffr

Certified Risk Adjustment Medical Coder (CRC) Our client is seeking an experienced Certified Risk Adjustment Medical Coder (CRC) to support CMS and HHS Risk Adjustment Data Validation (RADV) audits. This position is responsible for reviewing inpatient and outpatient medical records to validate Hierarchical Condition Categories (HCCs) while ensuring compliance with CMS documentation standards, ICD-10 coding guidelines, and regulatory requirements. The ideal candidate will have extensive experience performing CMS and HHS RADV audits, vendor-side coding reviews, and risk adjustment auditing while maintaining exceptional coding accuracy and productivity standards. Key Responsibilities Review inpatient and outpatient medical records to validate HCC diagnoses. Determine whether submitted diagnosis codes meet CMS and HHS documentation requirements. Ensure documentation satisfies M.E.A.T. (Monitor, Evaluate, Assess, Treat) criteria. Perform coding reviews using ICD-10 Official...

Seeking a full-time remote HCC / Risk Adjustment Medical Coder, the candidate will review and accurately code medical records in compliance with ICD-10-CM and CMS-HCC guidelines while ensuring data integrity and collaborating with healthcare providers. Key Responsibilities Review and accurately code medical records for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines Ensure coding compliance with ICD-10-CM, CMS-HCC, and other relevant guidelines, while validating the accuracy and completeness of coded data Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies, participating in coding education and audits Required Qualifications Minimum CPC or CCS certification from AHIMA or AAPC required; higher-level certifications such as CRC are preferred One to two years of experience in Risk Adjustment and HCC coding in a healthcare setting Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $26.00/hr - $27.00/hr Direct message the job poster from Insight Global Professional Recruiter at Insight Global We are looking for a full-time REMOTE HCC/Risk Adjustment Medical Coder for a contract up to 12 months with possible extensions or conversions. Must hold an active CPC or CCS, as well as 3+ years of HCC/risk adjustment coding experience. ****The pay rate is $25-26.50 per hour depending on experience**** Job Summary: Insight Global is hiring HCC/Risk Adjustment Medical coders to support a backlog for inpatient and outpatient Medicare Advantage projects. Candidates must obtain an active Coding certification (CPC) through AAPC or AHIMA. The role primarily involves risk adjustment coding, focusing on HCC ICD-10 codes. Experience with problem list coding is a plus but not required. Responsibilities include validating...

Prominence Health is seeking a Senior Coder responsible for documentation and coding review of medical records at partnered medical practices. This role involves working with provider offices to ensure accurate reporting of diagnoses and service codes. The position may require occasional onsite work and travel for provider education. Qualified candidates should have 3+ years of experience in CMS coding and certification, with the ability to communicate effectively and work independently in a #J-18808-Ljbffr

Prominence Health is seeking a Senior Coder to perform documentation and coding reviews for services rendered across partnered practices. You will ensure accurate diagnoses and service codes to support risk adjustment and quality measurement, with pre, post, and wraparound input. Some onsite work and occasional travel may be involved. Strong CMS coding knowledge, HCC experience, and EMR proficiency are essential. Bilingual Spanish is a plus, and CRC/AHIMA credentials are preferred. #J-18808-Ljbffr

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding accuracy...

Medical Coding Professional 2Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market.Responsibilities:Deliver coding and documentation education to providers and clinic staff within IPA clinics.Be a consultative resource and ongoing support for providers in assigned clinics.Conduct documentation audits to identify gaps, trends, and opportunities for improvement.Perform quarterly chart reviews to support coding accuracy and...

Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy, completeness, specificity and...

IPA Consultative Coding ProfessionalBecome a part of our caring community and help us put health first. The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with...

Medical Coding Specialist II Join the #1 hospital in Wisconsin! This is a full-time, 1.0 FTE position that is 100% remote. This will have flexible shifts scheduled Monday - Friday and will be discussed in the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work 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. At UW Health, you will have: An excellent benefits package, including health and dental insurance, paid time off, retirement plans, two-week paid parental leave and adoption assistance. Options for a variety of schedules and shifts that offer flexibility and allow for work-life balance. Access to great resources through the UW Health Employee Wellbeing Department that supports your emotional, financial, and...