• HCC Risk Adjustment

    Datavant (St. Paul, MN)
    …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 (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 . ... more risk adjustment vs profee. Most of the markets are strictly risk adjustment focusing on HCC ICD-10 codes only. We do code from the problem list… more
    Insight Global (07/26/25)
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  • 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 (06/12/25)
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  • Coder III (Medical Coding)

    Geisinger (Danville, PA)
    …certifications is required:CPC - Certified Professional Coder CRC - Certified Risk Adjustment Coder RHIT - Registered Health Information Technician ... 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 (06/04/25)
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  • Certified Coder - REMOTE

    Molina Healthcare (Scottsdale, AZ)
    Adjustment Data Validation **Preferred License, Certification, Association** + Certified Risk Adjustment Coder - (CRC) + Certified Professional Payer ... Education** Bachelor's Degree in related field **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model +… more
    Molina Healthcare (07/31/25)
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  • Senior Professional Coder

    Albany Medical Center (Albany, NY)
    …instruction and training to providers and coding staff. Act as an expert for the HCC / Risk adjustment coding. This position is remote but does require onsite ... America) Salary Range: $60,367.47 - $90,551.20 The Senior Professional Coder will apply an advanced professional coding skill set...for Coding and Reporting. Code chronic disease that meets HCC and Risk Adjustment criteria.… 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)
    …communication. + Experience with Electronic Health Record preferred. + Understanding Risk Adjustment coding and supportive documentation preferred. + Ability ... POSITION SUMMARY: The Physician Office Medical Coder /Biller (POMB) conducts a documentation review of electronic...will support the physician and mid-level providers to capture HCC codes within the clinical visit. The POMB will… more
    Florida Health Care Plans, Inc. (07/20/25)
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  • Clinical Quality Coder II

    Sutter Health (Sacramento, CA)
    …+ HS Diploma or General Education Diploma (GED) **CERTIFICATION & LICENSURE:** + CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder ... 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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  • Risk Adjustment Consultant

    Tufts Medicine (Burlington, MA)
    …provider education when necessary. **Job Description** **Minimum Qualifications:** 1. Certified Risk Adjustment Coder (CRC) **OR** Certified Professional ... experience, . **Preferred Qualifications:** 1. Associate's degree. 2. Certified Risk Adjustment Coder (CRC) highly...to physicians on a regular basis in regard to Risk Adjustment Coding guidelines ( HCC /DxCG),… more
    Tufts Medicine (07/14/25)
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  • Risk Adjustment Coding Specialist…

    Trinity Health (Albany, NY)
    …and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **. Certified Risk Adjustment Coder (CRC) required** . Excellent verbal ... system work queues and natural language processing (NLP) tools to support addressing HCC codes for Risk Adjustment before a claim is submitted to payers. .… more
    Trinity Health (07/31/25)
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  • Risk Adjustment Auditor Educator…

    Trinity Health (Syracuse, NY)
    …LICENSURE AND EXPERIENCE INCLUDES:** + Risk Adjustment Coding - Certified Risk Adjustment Coder (CRC) required and + Auditing - Certified Auditor ... Education if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for...to the PCP prior to their next visit. + HCC education and training will be conducted per Excellus… more
    Trinity Health (07/18/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    …certification or Certified Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Reliable transportation ... billing and/or coding, required + Three or more years of recent experience in CMS- HCC Risk Adjustment models V24 and V28, required + Three or more years… more
    UCLA Health (05/16/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …Technician (RHIT)** **o Registered Health Information Administrator (RHIA)** **o Certified Risk Adjustment Coder (CRC) certification** **Individuals who ... Job Summary: The Risk Adjustment Quality & Review Analyst... Model to confirm accuracy of Hierarchical Condition Categories ( HCC ) identified from abstracted ICD-10-CM diagnosis codes for the… more
    The Cigna Group (08/01/25)
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  • Certified Coding Specialist I- Health Plan- Remote

    UPMC (Pittsburgh, PA)
    …+ Code Inpatient, Outpatient, physician, and ED charts as necessary. + Assign Risk Adjustment HCC diagnoses by thoroughly reviewing all documentation ... procedure. + Review appropriate documents to accurately assign a Risk Adjustment HCC diagnosis. +...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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  • Quality Review and Audit Senior Analyst - RADV…

    The Cigna Group (Bloomfield, CT)
    …Information Technician (RHIT) + Registered Health Information Administrator (RHIA) + Certified Risk Adjustment Coder (CRC) certification (within 12 months ... coordination and implementation of daily processes related to IFP Risk Adjustment (RA) programs, including the ...in one of the following certifications: + Certified Professional Coder (CPC) + Certified Coding Specialist for Providers (CCS-P)… more
    The Cigna Group (07/31/25)
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  • 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 (07/09/25)
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  • Revenue Management Educator (Remote Option within…

    Marshfield Clinic (Marshfield, WI)
    …one year. State of Wisconsin Registered Nurse license (if applicable). **Preferred/Optional:** Certified Risk Adjustment Coder awarded by American Academy of ... external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the… more
    Marshfield Clinic (06/29/25)
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  • Quality Coding & Documentation Specialist

    AdventHealth (Altamonte Springs, FL)
    …Hierarchical Conditions Categories ( HCC ), ICD-10, medical necessity, and the appropriate Risk Adjustment Factor. Working with the Quality Team is not only ... patients is accurately depicted. This includes compliant documentation supporting HCC or capturing them, ICD-10, and medical necessity. +...the quality of clinical documentation, use of HCCs and Risk Adjustment of patients. **The expertise and… more
    AdventHealth (07/31/25)
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  • Clinical Documentation Specialist

    Ascension Health (Elk Grove Village, IL)
    …Candidates must have the following certification thru AAPC (credentialing board): **Certified Risk Adjustment Coder (CRC) - STRONGLY PREFERRED** + ... to hire date or job transfer date.* Certified Professional Coder (CPC) credentialed from the American Academy of Professional...in the CRC program please apply!** + 1 year ** RISK CODING** experience, preferred (NEW GRADUATES WELCOME) + Experience… more
    Ascension Health (07/31/25)
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  • Coding Auditor & Educator

    Trinity Health (Boise, ID)
    …Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing reviews of patient ... 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… more
    Trinity Health (05/28/25)
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