330 risk adjustment medical coder jobs found

Volunteers of America National Services (VOANS) is seeking a Medical Coder - Risk Adjustment Specialist based in Eden Prairie, Minnesota. In this role, you will partner with healthcare professionals to enhance coding accuracy, supporting the CMS reporting process under the PACE program. A strong emphasis is placed on collaboration and compliance with coding standards. The ideal candidate has at least five years of direct coding experience, relevant certifications, and strong communication skills. VOANS promotes a diverse and inclusive workplace. #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...

Humana is seeking a Medical Coder / Coding Educator 2 to drive education plans for providers and improve documentation quality. You will arrange training, analyze coding trends, and present findings to leadership, leveraging data visualization. This role emphasizes on-site education with some remote work and collaboration with market-facing teams. Qualifications include CPC certification, 3+ years in coding education or auditing, strong data analytics skills, and knowledge of Risk Adjustment and #J-18808-Ljbffr

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 specialization in in-home health...

CVS Health is seeking a Healthcare Records Auditor to perform audit and abstraction of medical records for CMS risk adjustment, ensuring accuracy and regulatory compliance. You will review physician documentation, assign diagnoses, and verify support in records, working to meet strict project deadlines while adhering to CMS and internal policies. This role emphasizes accuracy, accountability, and quality in a care-driven environment. #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

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and tailor education plans for assigned providers. The role reports to the Manager, Medicare Risk Adjustment and requires on-site sessions, data analytics, and collaboration with cross-functional teams. Responsibilities include developing reports on coding quality trends, providing education to providers, and ensuring adherence to internal and external standards. #J-18808-Ljbffr

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

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and tailor education plans. The role reports to the Manager, Medicare Risk Adjustment. You will arrange sessions with providers, analyze coding quality data, and deliver on-site education while collaborating with market provider-facing teams to improve documentation and risk adjustment outcomes. #J-18808-Ljbffr

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and tailor education plans for assigned providers. The role reports to the Manager, Medicare Risk Adjustment. You will arrange educational sessions, analyze reports to identify needs, and deliver data-driven education to improve coding quality and documentation accuracy across markets. #J-18808-Ljbffr

Suvida Healthcare is seeking a Risk Adjustment Coder to enhance documentation and coding accuracy in patient records. This role involves reviewing medical documents, providing feedback, and educating healthcare providers on coding standards to deliver high-quality care for our seniors. Ideal candidates will have a strong background in ICD-10 coding, possess excellent communication skills, and work well in a collaborative environment. Join us in making a meaningful impact within a diverse and dedicated team. #J-18808-Ljbffr

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and create tailored education plans for assigned providers, reporting to the Manager, Medicare Risk Adjustment. Responsibilities include arranging education sessions, analyzing coding quality trends with data visualization, delivering on-site education, and collaborating with market provider-facing roles to raise documentation standards. #J-18808-Ljbffr

Job Description Job Description Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program. Medical Coder - Risk Adjustment Specialist- Remote Schedule: M-F 8:00 AM-5:00 PM Salary: $58,000-$66,000 (Based on Experience) Essentials: Collaboration for Risk Adjustment Integrity: Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process. Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity. Medication Documentation Review and Diagnostic Coding: Reviews and interprets provider documentation to extract critical information. Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical...

Position Summary About Orlando Health At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida's east to west coasts and beyond. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. "Orlando Health Is...

Suvida Healthcare is seeking a Risk Adjustment Coder to enhance documentation and coding accuracy in patient records. This role involves reviewing medical documents, providing feedback, and educating healthcare providers on coding standards to deliver high-quality care for our seniors. Ideal candidates will have a strong background in ICD-10 coding, possess excellent communication skills, and work well in a collaborative environment. Join us in making a meaningful impact within a diverse and dedicated team. #J-18808-Ljbffr

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...

Certified Risk Adjustment Medical Coder (CRC) Key Details Location: 100% Remote (Must reside in an approved state) Duration: Contract (Potential for extension) Schedule: Monday-Friday, 7:00 AM-4:00 PM or 8:00 AM-5:00 PM (Local Time) Hours: 40 hours per week, with 5-10 hours of overtime as needed (Candidates must be willing to work overtime) Work Arrangement: Fully Remote Compensation: $27.00 per hour Employment Type: W2 (Not open to C2C, 1099, or visa sponsorship) Role Overview 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...

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...

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...

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

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 specialization in in-home health...

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