109 senior risk adjustment coder jobs found

HealthPartners in Minnesota is seeking a Risk Adjustment Coding Analyst Senior to review diagnosis coding and oversee vendor coding quality assurance. The role ensures that plan performance and revenue reflect the population's care needs and risks. The position requires strong chart review skills, knowledge of CPT/ICD coding, and experience with revenue cycle processes. Collaboration with providers and vendors is essential to maintain compliant coding practices. #J-18808-Ljbffr

Insight Global is seeking a Senior Medical Coder specializing in Risk Adjustment coding to review clinical data and assign ICD-10-CM codes that support risk adjustment and HCC reporting. The role requires meticulous chart review, strong coding compliance, and familiarity with CMS and Medicare Advantage rules. Collaboration with providers will enhance documentation quality and coding accuracy. #J-18808-Ljbffr

Astrana Health in Orange County seeks a Risk Adjustment Coding Specialist to support high-volume chart reviews and identify coding gaps for Medicare Advantage, ACA, and Commercial plans. You will translate findings into provider education, deliver insights, and track KPIs like HCC recapture rates and AWVs while traveling to provider offices as needed. This role supports a hybrid work model with on-site and field responsibilities. #J-18808-Ljbffr

Cano Health is seeking a Risk Adjustment Coder III to assign ICD-10-CM diagnoses from clinical records in line with established risk adjustment models. You will perform high-volume coding and chart reviews, ensuring data accuracy and regulatory compliance. The role requires CPC/CCS certification, 5 years of coding experience with risk adjustment, and proficiency with ICD-10-CM guidelines. Collaboration with clinical teams and ongoing education are essential. #J-18808-Ljbffr

Millennium Physician Group in Indiana is seeking a Risk Adjustment Coding Specialist II to review patient records after visits and translate documentation into provider-selected ICD-10-CM codes for claims processing. You will collaborate with the MRA Department to validate codes to the highest specificity, identify missing information, and maintain professional certifications while ensuring HIPAA compliance and timely submissions. #J-18808-Ljbffr

Millennium Physician Group is seeking a Risk Adjustment Coding Specialist II to translate patient encounters into ICD-10-CM codes for claims processing. The role emphasizes accuracy, compliance with ICD-10-CM guidelines, and collaboration within the MRA Department for concurrent outpatient coding. The candidate will abstract and assign codes supported by documentation, identify missing information, and communicate with providers when documentation is unclear or incomplete. #J-18808-Ljbffr

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II in Los Angeles area, reporting to the Supervisor - Risk Adjustment. This role requires frequent travel to provider sites and supports Medicare Advantage, ACA, and commercial coding. You will review medical records for HCC coding, perform audits, educate providers, and stay current with ICD-10/HCC guidelines. Strong communication and collaboration are essential, with a goal to meet productivity targets. #J-18808-Ljbffr

Astrana Health in Monterey Park, CA is seeking a Risk Adjustment coder to review and ensure accurate ICD-10-CM/HCC documentation across Medicare Advantage, ACA, and commercial lines. You will educate providers and work with IPAs to improve coding quality. You will travel up to 75% and balance on-site fieldwork with hybrid support, maintaining up-to-date knowledge of CMS guidelines and payer requirements while meeting productivity targets. #J-18808-Ljbffr

Astrana Health seeks a Risk Adjustment Coding Specialist II to join our Strategy and Operations team in Monterey Park, CA. The role requires converting provider documentation into compliant HCC coding and educating providers on CMS requirements while traveling to provider sites as needed. Qualified candidates hold CCS/CPC certification with 3+ years of risk adjustment coding experience, strong EHR skills, and the ability to work in a hybrid setting, including on-site visits and remote #J-18808-Ljbffr

Astrana Health Management in Houston is seeking a Risk Adjustment Coding Specialist II to drive risk adjustment efforts through chart reviews, provider education, and KPI reporting. You’ll translate findings into actionable insights and support education for providers and practice leaders while navigating complex conversations. Candidates should have 3–5 years in risk adjustment, CPC/CRC credentials, travel up to 75%, and strong communication skills. #J-18808-Ljbffr

Cano Health is seeking a Risk Adjustment Coder III to assign ICD-10-CM diagnoses from clinical records in line with established risk adjustment models. You will perform high-volume coding and chart reviews, ensuring data accuracy and regulatory compliance. The role requires CPC/CCS certification, 5 years of coding experience with risk adjustment, and proficiency with ICD-10-CM guidelines. Collaboration with clinical teams and ongoing education are essential. #J-18808-Ljbffr

Cano Health seeks a Risk Adjustment Coder III to assign ICD-10-CM codes from medical records, ensuring accuracy with HIPAA-compliant documentation. You will perform detailed chart reviews, apply CMS-HCC guidelines, and participate in audits to uphold data quality. Collaboration with clinical teams is essential. Qualified candidates have 5+ years in medical coding, CPC/CCS certification, and strong attention to detail. #J-18808-Ljbffr

Astrana Health is seeking a Risk Adjustment Coding Specialist to support Orange County operations. You will conduct high-volume chart reviews to identify coding gaps, then translate findings into education for providers and practice leaders, driving HCC recapture and KPI improvements. olla You will travel to provider offices up to 75% and collaborate with IPA teams, offering auditing and education to ensure CMS, Medicare and payer guidelines are met while staying current on ICD-10/HCC updates. #J-18808-Ljbffr

Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. Candidates should have 3-5 years of risk adjustment coding experience and be able to travel up to 75% for the role. You will review provider documentation, conduct education sessions, and ensure compliance with coding regulations. AAPC or AHIMA certification is required. The role offers a competitive salary range of $70,000 - $85,000 per year. #J-18808-Ljbffr

Astrana Health, Inc. is looking for a Risk Adjustment Coding Specialist II to support high-volume coding efforts in Orange County. This full-time position offers opportunities to analyze data and educate providers, requiring travel up to 75% of the time. The ideal candidate should have significant experience in risk adjustment coding, critical presentation skills, and a valid driver's license. Compensation ranges from $70,000 to $85,000 per year, depending on experience and location. #J-18808-Ljbffr

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

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

HealthPartners is hiring a Risk Adjustment Coding Analyst Senior. This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based on an accurate representation of our population's care needs and risks. ACCOUNTABILITIES: Performs retrospective chart review for diagnosis coding accuracy. Identifies, analyzes, and reports coding error trends to inform risk adjustment analytics and deliver provider education. Reviews vendor coding and provide recurring feedback and education to vendor team. Participates in internal and CMS-mandated risk adjustment data validation review. Identifies, documents, and messages process improvements, clinical documentation improvements and/or other educational opportunities. Develops and performs training and educational seminars to physicians and advanced practice providers on risk adjustment topics. Increases collaborative efforts...

Senior Medical Coder Specializing in Risk Adjustment Coding Required Skills & Experience: Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) Strong ICD-10-CM coding experience and medical record review background Knowledge of Risk Adjustment and HCC coding methodologies Experience reviewing physician documentation and assigning accurate diagnosis codes Strong understanding of medical terminology, anatomy, physiology, and disease processes Ability to interpret complex clinical documentation with high accuracy and productivity Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience: Medicare Advantage Risk Adjustment experience Experience working with CMS-HCC models CRC (Certified Risk Adjustment Coder) certification Experience with EMRs and coding software platforms Background in a health plan, physician practice, hospital, or revenue cycle environment Audit and quality assurance experience Job Description: Insight...

Job Description Insight Global is seeking a Senior Medical Coder specializing in Risk Adjustment Coding for a leading healthcare client. This professional will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting. The ideal candidate will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence. This role offers the opportunity to work closely with providers and healthcare teams to improve coding accuracy, enhance documentation quality, and support critical risk adjustment initiatives. Candidates with Medicare Advantage and HCC coding experience will be highly sought after. Day-to-Day: • Review medical records, physician documentation, and clinical data to identify reportable diagnoses • Assign accurate ICD-10-CM diagnosis codes based on coding guidelines and documentation • Identify...

Risk Adjustment Coding Analyst SeniorHealthPartners is hiring a Risk Adjustment Coding Analyst Senior.This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based on an accurate representation of our population's care needs and risks.Accountabilities:Performs retrospective chart review for diagnosis coding accuracy.Identifies, analyzes, and reports coding error trends to inform risk adjustment analytics and deliver provider education.Reviews vendor coding and provide recurring feedback and education to vendor team.Participates in internal and CMS-mandated risk adjustment data validation review.Identifies, documents, and messages process improvements, clinical documentation improvements and/or other educational opportunities.Develops and performs training and educational seminars to physicians and advanced practice providers on risk adjustment topics.Increases collaborative efforts...

Highmark Inc. is seeking a skilled risk adjustment coder to support Medicare Advantage and ACA programs. You will translate physician documentation into ICD-10 and HCC categories, driving accurate risk adjustment coding and documentation improvements. You will mentor colleagues, develop training materials, and deliver training via multiple formats, collaborating with quality, compliance, and provider teams to ensure CMS compliance and data integrity. #J-18808-Ljbffr