• HCC Risk Adjustment Coder - Full…

    Datavant (St. Paul, MN)
    …educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to ... on client specific guidelines for the project. + The coder will ensure compliance with established ICD-10 CM, third...CIC, or CRC). + A minimum of 2 years HCC coding experience, while certified. + Full understanding and… more
    Datavant (08/01/25)
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  • Remote HCC Coder

    Insight Global (Tampa, FL)
    Job Description Insight Global is hiring HCC /Risk Adjustment Medical coders to support a backlog for inpatient and outpatient Medicare advantage projects . Must ... of the markets are strictly risk adjustment focusing on HCC ICD-10 codes only. We do code from the...also be responsible to validate the CPT codes and non- HCC codes. These markets are still only reviewing Medicare… more
    Insight Global (07/26/25)
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  • Coder III (Medical Coding)

    Geisinger (Danville, PA)
    …for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and ... in decision making relevant to physician coding education and HCC targeting purposes. + Provides encoder software and EMR...year relevant experience). This posting reflects an opening for Coder III and we are seeking candidates for that… more
    Geisinger (06/04/25)
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  • Risk Adjustmt Coder Educator / Clinical…

    Hartford HealthCare (Hartford, CT)
    …other common practices across the system. *JOB SUMMARY:* The Risk Adjustment Coder Educator develops and implements an enterprise-wide risk adjustment coding and ... adjustment program requirements and ICD 10 coding guidelines. The Risk Adjustment Coder Educator will serve as a training resource for Risk Adjustment department… more
    Hartford HealthCare (06/12/25)
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  • Senior Professional Coder

    Albany Medical Center (Albany, NY)
    …Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Professional Coder will apply an advanced professional coding skill set to act as a ... and coding staff. Act as an expert for the HCC /Risk adjustment coding. This position is remote but does...& retrospective auditing) to ensure documentation and selection of HCC diagnosis codes meet the requirements set forth by… more
    Albany Medical Center (07/30/25)
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  • Physician Office Medical Coder /Biller II

    Florida Health Care Plans, Inc. (Daytona Beach, FL)
    POSITION SUMMARY: The Physician Office Medical Coder /Biller (POMB) conducts a documentation review of electronic records that are prepared by clinicians to ensure ... will support the physician and mid-level providers to capture HCC codes within the clinical visit. The POMB will...within the clinical visit. The POMB will track the HCC codes that still need to be addressed. The… more
    Florida Health Care Plans, Inc. (07/20/25)
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  • Certified Coder - REMOTE

    Molina Healthcare (Scottsdale, AZ)
    …and experience **Required License, Certification, Association** + Certified Professional Coder (CPC) + Certified Coding Specialist (CCS) **Preferred Education** ... Bachelor's Degree in related field **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model + Background in supporting… more
    Molina Healthcare (07/31/25)
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  • Clinical Quality Coder II

    Sutter Health (Sacramento, CA)
    …General Education Diploma (GED) **CERTIFICATION & LICENSURE:** + CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding ... of Quality Coding Program requirements such as the Medicare Advantage Coding Program/ HCC , as well as medical terminology and abbreviations of disease, illness and… more
    Sutter Health (06/29/25)
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  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …an internal expert on Risk Adjustment and Hierarchical Conditions Categories ( HCC ) coding. Specific duties include performing concurrent and retrospective reviews of ... Monitors and reports key performance indicators relative to clinical documentation and HCC coding. . Documents and maintains records of all query, audit, and… more
    WMCHealth (07/09/25)
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  • Certified Coding Specialist I- Health Plan- Remote

    UPMC (Pittsburgh, PA)
    …exciting opportunity for a Certified Coding Specialist I position in the Medicare HCC department. This is a full time position working Monday through Friday daylight ... and ED charts as necessary. + Assign Risk Adjustment HCC diagnoses by thoroughly reviewing all documentation in the...95% as well as coding productivity standards. + Complete coder productivity and time log daily. + Adhere to… more
    UPMC (07/30/25)
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  • Risk Adjustment Consultant

    Tufts Medicine (Burlington, MA)
    …ICD-10-CM coding standards, as well as lead efforts to evaluate the HCC /DxCG coding practices and provide analyses and recommendations to improve overall provider ... when necessary. **Job Description** **Minimum Qualifications:** 1. Certified Risk Adjustment Coder (CRC) **OR** Certified Professional Coder (CPC). 2. Two… more
    Tufts Medicine (07/14/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories ( HCC ) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit ... the American Academy of Professional Coders (AAPC):** **o Certified Professional Coder (CPC)** **o Certified Coding Specialist for Providers (CCS-P)** **o Certified… more
    The Cigna Group (08/01/25)
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  • Revenue Management Educator (Remote Option within…

    Marshfield Clinic (Marshfield, WI)
    …Terminology (CPT), and ICD‐9, ICD-10 and Hierarchical Condition Category ( HCC ) coding. **Preferred/Optional:** Bachelor of Science in Nursing. **EXPERIENCE** ... ICD‐9 and ICD‐10 codes, Healthcare Common Procedure Coding System (HCPCS) codes, HCC coding, use of modifiers, documentation guidelines, CMS Policy requirements, and… more
    Marshfield Clinic (06/29/25)
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  • Risk Adjustment Coding Specialist -St. Peter's…

    Trinity Health (Albany, NY)
    …responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and MEAT (Monitored, Evaluated/Assessed/Addressed, Treated) ... (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **. Certified Risk Adjustment Coder (CRC) required** . Excellent verbal and written communication skills. .… more
    Trinity Health (07/31/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (OH)
    …to allow for monitoring and evaluation of trends in DRG (MS/APR-DRG), APC, HCC , other Heath Risk Adjusted Factors, National Correct Coding Initiative (NCCI) and the ... required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC)...Certified Inpatient Coder (CIC) or Certified Professional Coder (CPC) or Certified Outpatient Coder (COC)… more
    Banner Health (06/15/25)
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  • Quality Coding & Documentation Specialist

    AdventHealth (Altamonte Springs, FL)
    …This will include compliant documentation to support Hierarchical Conditions Categories ( HCC ), ICD-10, medical necessity, and the appropriate Risk Adjustment Factor. ... of the patients is accurately depicted. This includes compliant documentation supporting HCC or capturing them, ICD-10, and medical necessity. + Knowledge and deep… more
    AdventHealth (07/31/25)
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  • Quality Review and Audit Senior Analyst - RADV…

    The Cigna Group (Bloomfield, CT)
    …Coders (AAPC) in one of the following certifications: + Certified Professional Coder (CPC) + Certified Coding Specialist for Providers (CCS-P) + Certified Coding ... (RHIT) + Registered Health Information Administrator (RHIA) + Certified Risk Adjustment Coder (CRC) certification (within 12 months of hire) + Experience with… more
    The Cigna Group (07/31/25)
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  • Clinical Documentation Specialist

    Ascension Health (Elk Grove Village, IL)
    …obtained prior to hire date or job transfer date.* Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders(AAPC) obtained ... the following certification thru AAPC (credentialing board): **Certified Risk Adjustment Coder (CRC) - STRONGLY PREFERRED** + **Hybrid position** - Flexible with… more
    Ascension Health (07/31/25)
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  • Coding Auditor & Educator

    Trinity Health (Boise, ID)
    …the Centers for Medicare and Medicaid Services (CMS). Monitor's accuracy of centralized coder 's charge capture and coding with proper ICD-10, CPTs, HCPCs, as well as ... Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and... and other Risk Adjustment capture with provider and coder education. Conducts ongoing reviews of patient medical record… more
    Trinity Health (05/28/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    …highly organized, detail-oriented individual with: + A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification, required ... + A Certified Risk Adjustment Coder (CRC), required + Reliable transportation to conduct ongoing...+ Three or more years of recent experience in CMS- HCC Risk Adjustment models V24 and V28, required +… more
    UCLA Health (05/16/25)
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