18 senior risk adjustment coder ii jobs found

Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines. The role supports Commercial and Medicare risk adjustment programs and helps ensure accurate documentation and coding. The coder will contribute to trainings, audits, and collaboration across departments to improve documentation quality and compliance. #J-18808-Ljbffr

Direct Jobs is seeking a Risk Adjustment Coder II in Houston, Texas. This role involves advanced support for medical record reviews, ensuring correct capture of chronic conditions and compliance with CMS guidelines. The Coder II acts as a subject matter expert, facilitating team training and audits. The ideal candidate will have a Bachelor's degree or equivalent experience in risk adjustment, along with relevant coding certifications. Experience in Commercial and Medicare coding is required alongside strong analytical and communication skills. #J-18808-Ljbffr

Community Health Choice, Inc. seeks a Risk Adjustment Coder II in Houston, Texas. The role involves advanced medical record reviews and coding of chronic conditions to ensure correct risk scoring, complying with CMS guidelines and internal policies. The ideal candidate has a Bachelor's degree or equivalent experience, and AHIMA/AAPC certification, along with 3-5 years of experience in risk adjustment coding. Join a team dedicated to improving healthcare quality for over 400,000 members. #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...

Risk Adjustment Coder 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...

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...

GoTo Telemed seeks an exceptional Remote Medical Biller to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide.As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers--with new clients and provider networks added every month as our organization scales.In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management.Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory.This position...

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

At Suvida Healthcare, we are not just caregivers; we're compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well-being of an underserved community and their families. Our multi-disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare-eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both, our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service-centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This role is available for remote, onsite and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office applications...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a hybrid role. Training is onsite Full Time, then Hybrid once trained. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office...

Certified Medical Coder I (Professional Review Specialist I) The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This role is available for remote, onsite and hybrid work arrangements. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C...

CERIS Certified Coder I Job Category: CERIS Requisition Number: CERIS011106 Posted: March 25, 2026 Full-Time Fort Worth, TX 76109, USA Description The CERIS Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This role is responsible for making claim-related recommendations and communicating status of the claim to involved stakeholders. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations and communicates claim status to referring office Read and comprehend all medical reports Adhere to client and carrier guidelines and participate in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Maintain HIPAA compliance Additional duties as assigned KNOWLEDGE &...

Job Summary The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. ***Position eligible for Telecommuting with consideration for a fully remote arrangement within Washington State, depending on experience (DOE)*** Job Specific Competencies Team Leadership & Oversight Supervises coding staff including Coder I and Coder II. b. Monitors productivity and quality metrics, ensuring standards are met or exceeded. c. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance Oversees internal/external audits and reviews coding accuracy,...

At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

Medical Coding Supervisor The Coding Supervisor is responsible for overseeing the daily operations of the coding team, ensuring accurate and compliant coding practices across all clinical departments. This role provides leadership, training, and quality assurance for coding staff, supports provider education, and collaborates with Revenue Cycle and Compliance teams to optimize reimbursement and maintain regulatory compliance. Team Leadership & Oversight: Supervises coding staff including Coder I and Coder II. Monitors productivity and quality metrics, ensuring standards are met or exceeded. Conducts regular team meetings and one-on-one check-ins to support performance and development. Quality Assurance & Compliance: Oversees internal/external audits and reviews coding accuracy, documentation, and billing compliance. Ensures adherence to federal, state, and payer-specific coding guidelines. Coordinates with Compliance and Revenue Cycle teams to resolve audit findings...

At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

Ceris Certified Coder ICeris is seeking a Certified Coder. The Ceris Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role.Essential Functions & Responsibilities:Receives claim and processes based on state rules and regulationsDetermines validity and compensability of the claim using CorVel proprietary programsMakes recommendations to referring officeCommunicates claim status with referring officeReads and comprehends all medical reportsAdheres to client and carrier guidelines and participates in claims review as neededAssists other claims professionals with more complex or problematic claims as necessaryAdditional duties/responsibilities as assignedComplies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (IIPP), as well as, maintains HIPAA complianceKnowledge & Skills:Ability to learn rapidly to develop knowledge and understanding of claims practiceStrong...