• Risk Adjustment Coding

    LA Care Health Plan (Los Angeles, CA)
    Risk Adjustment Coding Auditor II Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, ... to support the safety net required to achieve that purpose. Job Summary The Risk Adjustment Coding Auditor II position is responsible for auditing… more
    LA Care Health Plan (11/22/25)
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  • Auditor , HCC Risk Adjustment

    Datavant (Indianapolis, IN)
    …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...to the table:** + Minimum 3 years of HCC coding experience + Minimum 2 years of HCC Auditing… more
    Datavant (11/07/25)
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  • Analyst, Coding Data Quality Auditor

    CVS Health (Springfield, IL)
    …Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required **Preferred Qualifications** + CPMA (Certified ... Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and...proficiency in the following: + Proven ability to support coding judgment and decisions using industry standard evidence and… more
    CVS Health (11/21/25)
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  • Professional Coding Auditor - Remote

    Albany Medical Center (Albany, NY)
    …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 ... $60,367.47 - $90,551.20 This position has remote opportunity Professional Coding Auditor will apply an advanced professional...and Reporting. Code chronic disease that meets HCC and Risk Adjustment criteria. Validate missed coding more
    Albany Medical Center (11/05/25)
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  • Physician Billing (PB) Coding

    Hackensack Meridian Health (Hasbrouck Heights, NJ)
    …and serve as a leader of positive change. The **Physician Billing (PB) Coding Auditor and Educator** is responsible for auditing and educating healthcare ... obtain within one (1) year of hire. **Licenses and Certifications Preferred:** + Certified Risk Adjustment Coder (CRAC). If you feel that the above description… more
    Hackensack Meridian Health (11/01/25)
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  • Compliance Auditor - Medical Coding

    Geisinger (Danville, PA)
    …one Coding Certification required:--Certified Professional Coder - AAPC --Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC) ... Information Technician (RHIT) - American Health Information Management Association; Certified Risk Adjustment Coder - American Academy of Professional Coders… more
    Geisinger (10/18/25)
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  • Coding Data Quality Auditor

    CVS Health (Springfield, IL)
    …or CCS-P (Certified Coding Specialist-Physician) required. + CRC (Certified Risk Adjustment Coder). + Computer proficiency including experience with ... Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and...internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and… more
    CVS Health (11/14/25)
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  • Network Practice Coder/ Auditor

    WMCHealth (Valhalla, NY)
    …in a large multispecialty practice setting, including surgical speacialties is required. HCC Risk adjustment Coding esperience is preferred. Education: High ... Network Practice Coder/ Auditor Company: NorthEast Provider Solutions Inc. City/State: Valhalla,...Terminology (CPT) and Health Care Financing Administration Common Procedures Coding System (HCPCS) and identifying opportunities for improvement as… more
    WMCHealth (11/01/25)
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  • Market Director Population Health Quality…

    Catholic Health Initiatives (Little Rock, AR)
    …the value hub. + Through Risk Management/ Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... and guidelines for these new processes. + Support the Risk Auditor Manager of closely working with...Health Management experience required + Must have experience with risk adjustment coding and value… more
    Catholic Health Initiatives (11/15/25)
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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 ... concurrent and retrospective reviews of documentation and coding and working with providers and staff to ensure the accuracy and completeness of medical record… more
    WMCHealth (09/12/25)
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  • Quality Improvement CDI Specialist

    NCH (Naples, FL)
    …well as applicable organizational policies and procedures. * Experience in MS-DRG and APR-DRGs, risk adjustment , HACs and PSIs, O/E mortality, and LOS. * Working ... opportunities for documentation clarification, act as a liaison between coding and CDI to resolve DRG or other code...clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective… more
    NCH (11/14/25)
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  • Clinical Documentation Specialist, Second Reviewer

    SSM Health (MO)
    …scoring. + Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings. + Maintains knowledge of Centers ... Performs as a vital member of the interdisciplinary care team member, an auditor , and an educator ensuring medical records are complete and clinical documentation… more
    SSM Health (11/21/25)
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  • Underwriting Support Specialist

    AIG (Atlanta, GA)
    …of the unit's field operations. This role assists the underwriters by screening risk offerings and with pre and post-binding processes. The role also performs ... Review new submissions against prescribed criteria to determine if risk qualifies for LOB risk appetite. Triages...coverages and program structures, as well as internal policy coding systems to ensure account completeness. + Designated as… more
    AIG (11/12/25)
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