122 senior risk adjustment coder jobs found

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

Prominence Health is seeking a Senior Coder to review medical records and ensure accurate reporting of diagnoses and codes across partner practices. This role supports risk adjustment and quality measurement with pre, post, and wraparound input. Occasional onsite work at provider offices is required, with travel to out-of-state trainings. Strong CMS/HCC coding knowledge and bilingual capability (Spanish preferred) enhance success in this role. #J-18808-Ljbffr

Prominence Health, a value-based care organization, seeks a Senior Coder to review medical records and ensure accurate coding for diagnosis and service codes across partner practices. The role involves pre, post, and wraparound visit input and may require occasional onsite work and travel for provider education. The ideal candidate has CMS coding knowledge, 2+ years in Risk Adjustment Coding, and CRC/AAPC credentials, with bilingual Spanish preferred and experience navigating EMR systems. #J-18808-Ljbffr

Universal Health Services is seeking a Senior Coder to handle the documentation and coding review for medical records across partnered practices. Candidates must have a deep understanding of CMS coding and at least 3 years of experience in this field. The role requires both remote work and occasional onsite visits. This position offers a rewarding and challenging work environment along with competitive benefits, including a Loan Forgiveness Program and excellent medical plans. #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 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

Millennium Healthcare Management Serv LLC is seeking a Risk Adjustment Coding Specialist to review and validate provider documentation for accurate ICD-10-CM coding reflecting illness severity and care complexity. The role involves prospective, concurrent, and retrospective chart reviews, collaboration with providers, adherence to Medicare guidelines, and participation in coding education to sustain a high accuracy rate and productive coding output. #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

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to join the Quality - Risk Adjustment team in Orange, CA. The role requires expertise in Medicare Advantage, ACA, and commercial risk adjustment coding, with significant travel to provider sites to support coding education and standards. The ideal candidate will hold CCS/CPC (AAPC/AHIMA) certification, have 3+ years of risk adjustment experience, and be proficient with EHR and coding software. #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

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Senior Coder is responsible for documentation and coding...

Pride Health is seeking a Senior Medical Coder for a remote contract role. The position runs 8am–5pm with a 6-month term and potential extension. Pay ranges from $18 to $20 per hour and compensation is based on experience, credentialing, and education. AAPC or AHIMA certification is required, with at least 3 years of coding experience. Responsibilities include reviewing records, applying ICD-10-CM, CPT, HCPCS, and modifier codes, and performing CMS-HCC/risk adjustment coding as appropriate. #J-18808-Ljbffr

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The Senior Coder is responsible for documentation...

Senior Risk Adjustment CoderThe Senior Risk Adjustment Coder will perform code audits and abstraction in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare Advantage Risk Adjustment.What you will do:Risk Adjustment ReviewMay perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditingReviewing medical records to ensure accurate HCC coding and identify opportunities for recapture and suspect diagnoses.Evaluating medical records to verify that M.E.A.T criteria support the submitted diagnosis codes.Inquire with clinicians the recommended HCC diagnosis for chart addendum.Collaborating with other departments to address coding updates and support risk adjustment programs.Compliance...

Blue Cross Blue Shield of Arizona seeks a Quality Assurance Coder/Auditor to lead risk mitigation education for primary care providers and staff. You will review records, identify at-risk HCCs, and suggest coding improvements based on Medicare guidelines. The role requires CCS-P/CRC/CPC/COC credentials, 5+ years in coding with HCC, and 2+ years auditing; hybrid role within Arizona, standard 40 hours weekly, with ongoing education duties. #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...

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...

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...