• HCC Risk Adjustment Coder - Full…

    Datavant (Washington, DC)
    …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 (08/26/25)
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  • Remote HCC Coder (CPC)

    Insight Global (Tampa, FL)
    Job Description JOB DESCRIPTION Insight Global is hiring HCC /Risk Adjustment Medical coders to support a backlog for inpatient and outpatient Medicare advantage ... 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 (09/12/25)
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  • Auditor, HCC Risk Adjustment Coding - Full…

    Datavant (Denver, CO)
    …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and ... you will bring to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of HCC Auditing experience + High school diploma or GED equivalent +… more
    Datavant (08/08/25)
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  • Coding Team Lead, HCC Risk Adjustment…

    Datavant (Hartford, CT)
    …to realize our bold vision for healthcare. We're looking for experienced and credentialed HCC Coding Team Leads to become an integral part of our team. The ideal ... Reviews rebuttals submitted by coders. Provides education to the coder if the error is correct or sends the...+ Extensive knowledge of ICD -10 + 2 years' HCC coding experience + 1+ years' Team Lead experience… more
    Datavant (09/10/25)
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  • Value Based Coder II

    Dignity Health (Phoenix, AZ)
    …and/or HCC /risk adjustment coding preferred. - Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) strongly preferred. **Overview** ... a Dignity Health and Abrazo Health (Tenet) physician collaboration. The Value Based Coder is an employee of Inland Health Organization of Southern California, Inc.,… more
    Dignity Health (08/01/25)
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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 (09/11/25)
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  • Risk Adjustment Medical Record Coder

    BlueCross BlueShield of Tennessee (Chattanooga, TN)
    …Risk Adjustment division at BCBST is looking to add a Risk Adjustment Medical Record Coder to our team\.** Expertise in HCC coding, with a background in Medicare ... pass reviews of medical records and physician assessment forms \( HCC coding\)\. + Assist with the intake and quality...RHIT, RHIA\)\. + Must acquire the Certified Risk Adjustment Coder \(CRC\) certificate from AAPCwithin one year, after completed… more
    BlueCross BlueShield of Tennessee (09/16/25)
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  • Certified Risk Adjustment Coder (CRC),…

    Ankura (Los Angeles, CA)
    …Coding (CRC) with at least five (5) recent years of experience in HCC /Risk Adjustment and/or RADV Audit Methodology + Associate's or Bachelor's degree preferred, but ... not required + Strong understanding of clinical terminology, disease processes, anatomy and pharmacology. + Intermediate to advanced understanding of in claims processing procedures, state and federal regulations, and Medicare Part D requirements. + Excellent… more
    Ankura (09/09/25)
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  • Coding Auditor - Sharp Health Plan Administration…

    Sharp HealthCare (San Diego, CA)
    …a certified coder . + 2 years' experience working as an HCC risk adjustment coding auditor. + Experience with medical billing, medical terminology, understanding ... **Shift Start Time** **Shift End Time** HS Diploma or Equivalent; Certified Professional Coder (CPC) - AAPC; Certified Coding Specialist (CCS) - The American Health… more
    Sharp HealthCare (08/20/25)
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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 (09/12/25)
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  • Coding and Clinical Documentation Educator

    AdventHealth (Daytona Beach, FL)
    …with providers and operations to effectively provide Hierarchical Condition Category ( HCC ) education including but not limited to clinical documentation integrity, ... coding, HCC Risk Adjustment Methodology, and provider performance metrics. The...**Preferred qualifications:** + Bachelor's degree + Certified Risk Adjustment Coder (CRC) This facility is an equal opportunity employer… more
    AdventHealth (09/16/25)
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  • Risk Adjustment Coding Coordinator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …of ICD-9-CM/ICD-10-CM coding, Medicare Advantage and Commercial Hierarchical Condition Category ( HCC ) coding, and Medicaid Clinical Risk Groups (CRGs) to ensure ... to peer guidance through informal discussion and over read assignments. Supports coder training and orientation as requested by leadership. * Maintains accuracy in… more
    Excellus BlueCross BlueShield (08/27/25)
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  • Certified Risk Adjustment Coding/Audit Specialist

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …Risk Adjustment (MRA) ICD - 10 codes and Hierarchical Condition Categories ( HCC 's) Completes assignments with an emphasis on completeness, accuracy, and supporting ... and in the services we provide. RECRUITMENT REQUIREMENTS High School Graduate. Certified coder CPC or CCS-P, and AAPC CRC certification. 2+ years coding, Medicare… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Clinical Compliance Medical Director

    Elevance Health (Cincinnati, OH)
    …background. **Preferred Skills, Capabilities and Experiences:** + Deep understanding of CMS- HCC and/or HHS- HCC risk adjustment methodologies strongly preferred. ... compliance, and legal matters strongly preferred. + Certified Risk Adjustment Coder (CRC) or similar credential strongly preferred. + Experience with clinical… more
    Elevance Health (09/12/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (AR)
    …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 (09/06/25)
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  • Clinical Documentation Improvement Manager

    Cleveland Clinic (Cleveland, OH)
    …risk of mortality, MCC/CC capture, appropriate POA assignment, PSI, HAC, APC & HCC coding, risk adjustment analysis and provider queries. + Perform and/or monitor ... (CCS/P) from American Health Information Management Association OR Certified Professional Coder (CPC) from the American Academy of Professional Coders OR Certified… more
    Cleveland Clinic (09/12/25)
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  • Risk Adjustment QA Consultant

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

    East Boston Neighborhood Health Center (Revere, MA)
    …regulations, and clinical documentation improvement Certifications: + Required: Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC) + ... specialties + Extensive knowledge of cpt, revenue codes, ICD-10-CM coding and HCC /risk adjustment methodologies + Experience with Medicare Advantage risk models and… more
    East Boston Neighborhood Health Center (09/16/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …following certifications, or comparable medical coding specialty: + **Certified Professional Coder (CPC)** + **Certified Coding Specialist for Providers (CCS-P)** + ... **Registered Health Information Administrator (RHIA)** + **Certified Risk Adjustment Coder (CRC) certification required** + Proficiency with ICD-10-CM diagnostic… more
    The Cigna Group (09/16/25)
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  • Quality Auditor/Educator

    AdventHealth (Altamonte Springs, FL)
    …leadership. The Corporate QA is responsible for initial audits during the coder onboarding process for assigned staff, as well as supporting on-going quality ... Conditions (HAC), Patient Safety Indicators (PSI), and Hierarchical Condition Categories ( HCC ) + Expert level knowledge of medical terminology, coding guidelines and… more
    AdventHealth (09/16/25)
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