• HCC Risk Adjustment

    Datavant (Providence, RI)
    …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code… more
    Datavant (10/03/25)
    - Save Job - Related Jobs - Block Source
  • Auditor, HCC Risk Adjustment

    Datavant (Denver, CO)
    …educational and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records ... standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...bring to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of … more
    Datavant (08/08/25)
    - Save Job - Related Jobs - Block Source
  • Coding and Documentation Specialist - Hierarchical…

    Bon Secours Mercy Health (Cincinnati, OH)
    …leadership. + Identifies opportunities for performance improvement related to system-wide RSA and HCC and other risk adjustment coding initiatives. Works ... Coder (CPC) or Certified Coding Specialist (CCS) (required) Certified Risk Coder (CRC) or equivalent (preferred) **Education** Bachelor's Degree (preferred)… more
    Bon Secours Mercy Health (10/04/25)
    - Save Job - Related Jobs - Block Source
  • Risk Adjustmt Coder Educator…

    Hartford HealthCare (Hartford, CT)
    …recognition programs and other common practices across the system. *JOB SUMMARY:* The Risk Adjustment Coder Educator develops and implements an ... program requirements and ICD 10 coding guidelines. The Risk Adjustment Coder Educator will...of complex and advanced ICD-10 and Hierarchical Condition Category ( HCC ) coding and documentation training programs including defining training… more
    Hartford HealthCare (09/11/25)
    - Save Job - Related Jobs - Block Source
  • Coder

    Dignity Health (Bakersfield, CA)
    …on all coding systems and sponsored programs. - Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements. - Must ... to identify opportunities for improved quality, risk adjustment coding performance. The Value Based Coder ...Word). **Preferred Qualifications:** - 2-3 years of experience in risk adjustment / HCC coding preferred -… more
    Dignity Health (10/02/25)
    - Save Job - Related Jobs - Block Source
  • Coder (medical coding)

    Geisinger (Danville, PA)
    …Requirements: One of the following certifications is needed at time of hire: Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC) ... in decision making relevant to physician coding education and HCC targeting purposes. + Provides encoder software and EMR...Technician (RHIT) - American Health Information Management Association; Certified Risk Adjustment Coder - American… more
    Geisinger (09/30/25)
    - Save Job - Related Jobs - Block Source
  • Risk Adjustment Coding Coordinator…

    Excellus BlueCross BlueShield (Rochester, NY)
    …and guidelines (eg ICD-9-CM, ICD-10, CPT, HCPC) * Familiarity and understanding of CMS HCC Risk Adjustment coding, Medicaid CRG coding, and data validation ... / ICD-10-CM coding validation, monitoring plan specifications, Hierarchical Condition Category ( HCC ) assignment accuracy and Risk Adjustment Validation… more
    Excellus BlueCross BlueShield (08/27/25)
    - Save Job - Related Jobs - Block Source
  • Certified Risk Adjustment

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …work experience + AAPC or AHIMA Certification (CPC, CRC, CCS) REQUIRED + Certified Risk Adjustment Coder - PREFERRED Knowledge + Knowledgeable of medical ... services we provide. RECRUITMENT REQUIREMENTS High School Graduate. Certified coder CPC or CCS-P, and AAPC CRC certification. 2+...a wide variety of clinical cases and services for risk adjustment models (eg, HCC ,… more
    Redeemer Health Home Care & Hospice (08/13/25)
    - Save Job - Related Jobs - Block Source
  • Risk Adjustment QA Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk Adjustment Coder (CRC) certification * In-depth knowledge of ACA & Medicare ... as CPMA, RHIT, RHIA, CCA, CCS. * Expertise in CMS- HCC , and HHS- HCC Risk Adjustment models. Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
    - Save Job - Related Jobs - Block Source
  • Manager, Risk Adjustment Coding…

    Evolent (Phoenix, AZ)
    …or equivelent years of work experience. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder ) or demonstrated ability.** + 5+ years of ... knowledge, understanding industry standards and regulations in healthcare coding, specifically Risk Adjustment and all HCC models to ensure compliance with… more
    Evolent (09/23/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Improvement Specialist…

    Bluestone Physician Services (Stillwater, MN)
    …+ Bachelor's degree in Health Information Management, Nursing, or related field. + Certified Risk Adjustment Coder (CRC) certification, Risk ... healthcare coding, with a focus on Hierarchical Condition Category ( HCC ) coding and risk adjustment ....on Hierarchical Condition Category ( HCC ) coding and risk adjustment . Knowledge/Skills/Abilities + Proficiency in reviewing… more
    Bluestone Physician Services (09/07/25)
    - Save Job - Related Jobs - Block Source
  • Risk Score Accuracy (RSA) Program Manager…

    Bon Secours Mercy Health (Cincinnati, OH)
    …to Population Health Clinical Integration RSA initiatives, including Hierarchical Condition Categories ( HCC ) coding and other risk adjustment payment models. ... + Identifies opportunities for performance improvement related to system-wide HCC and other risk adjustment ...of hire, required within one year of hire) Certified Risk Coder (or equivalent), Licensed Practical Nurse… more
    Bon Secours Mercy Health (10/04/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Data Abstraction Specialist

    Apex Health Solutions (Houston, TX)
    …Specialist Supervisor: Director, VBC Operations Required License(s)/ Certification(s): Certified Risk Adjustment Coder (CRC), Certified Professional ... in one of the following is required: * Certified Risk Adjustment Coder (CRC) *...Records (EHR) Experience * Minimum of three (3) years HCC experience performing retrospective risk adjustment more
    Apex Health Solutions (09/26/25)
    - Save Job - Related Jobs - Block Source
  • Coding and Clinical Documentation Educator

    AdventHealth (Daytona Beach, FL)
    HCC ) education including but not limited to clinical documentation integrity, coding, HCC Risk Adjustment Methodology, and provider performance metrics. ... successful candidate will have an advanced understanding of the HCC risk adjustment methodology gained...Practitioner (CDIP) **Preferred qualifications:** + Bachelor's degree + Certified Risk Adjustment Coder (CRC) This… more
    AdventHealth (09/23/25)
    - Save Job - Related Jobs - Block Source
  • Quality Coding and Documentation Educator I,…

    Geisinger (Danville, PA)
    …(AAPC) Level III and IV Certified Professional Coder (AAPC) and Certified Risk Adjustment Coder (AAPC) Education Graduate from Specialty Training ... Minimum of 1 year-Related work experience (Required) Certification(s) and License(s) Certified Risk Adjustment Coder - American Academy of Professional… more
    Geisinger (09/24/25)
    - Save Job - Related Jobs - Block Source
  • Compliance Auditing Specialist- Remote/Hybrid…

    WMCHealth (Valhalla, NY)
    …Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories ( HCC ) coding. Specific duties include performing ... reports key performance indicators relative to clinical documentation and HCC coding. . Documents and maintains records of all...with one or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder more
    WMCHealth (09/12/25)
    - Save Job - Related Jobs - Block Source
  • Sr Coding Compliance Auditor

    Catholic Health Initiatives (Chattanooga, TN)
    …team to support the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition ... Category ( HCC ) Quality program was developed by CMS to promote...clinicians, and committees as appropriate. + Reports areas of risk directly to the Coding Integrity Manager/Supervisor. + Maintains… more
    Catholic Health Initiatives (10/04/25)
    - Save Job - Related Jobs - Block Source
  • Quality Senior Analyst

    CVS Health (IL)
    Coder ) **or** CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder ) required. + CPMA (Certified Professional ... + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ( HCC ) required. + Completion… more
    CVS Health (09/30/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Compliance Medical Director

    Elevance Health (Grand Prairie, TX)
    …Skills, Capabilities and Experiences:** + Deep understanding of CMS- HCC and/or HHS- HCC risk adjustment methodologies strongly preferred. + Experience ... MA plans in regulatory, compliance, and legal matters strongly preferred. + Certified Risk Adjustment Coder (CRC) or similar credential strongly preferred.… more
    Elevance Health (09/24/25)
    - Save Job - Related Jobs - Block Source
  • Analyst, Coding Data Quality Auditor

    CVS Health (IN)
    Coder ) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder ) required **Preferred Qualifications** + CPMA ... Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and...with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ( HCC )… more
    CVS Health (10/02/25)
    - Save Job - Related Jobs - Block Source