• Certified Coder ( Risk

    Molina Healthcare (Orlando, FL)
    Adjustment Data Validation **Preferred License, Certification, Association** + Certified Risk Adjustment Coder - (CRC) + Certified Professional Payer ... to network of providers on how to improve their risk adjustment knowledge as well as provide...such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education + Assists… more
    Molina Healthcare (08/21/25)
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  • Manager, Risk Adjustment Coding…

    Evolent (Charleston, WV)
    …administration, or a related field. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder ) or demonstrated ability.** + 5+ years of ... a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be Doing:** + Hires and oversees the initial… more
    Evolent (08/14/25)
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  • HCC Risk Adjustment Coder

    Datavant (Topeka, KS)
    …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to...Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the… more
    Datavant (08/23/25)
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  • Director, Registered Nurse/Certified Risk

    Ankura (New York, NY)
    …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
    Ankura (07/22/25)
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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 ... with CMS risk adjustment program requirements and ICD 10 coding guidelines. The Risk Adjustment Coder Educator will serve as a training resource for … more
    Hartford HealthCare (06/12/25)
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  • Value Based Coder II

    Dignity Health (Phoenix, AZ)
    …Qualifications:** - 2-3 years of experience in outpatient coding preferred. - Certified Risk Adjustment Coder (CRC) or Certified Professional Coder ... staff across the network to identify opportunities for improved quality, risk adjustment coding performance. The Value Based Coder II is a valuable resource… more
    Dignity Health (08/01/25)
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  • Physician Office Medical Coder

    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 ... communication. + Experience with Electronic Health Record preferred. + Understanding Risk Adjustment coding and supportive documentation preferred. + Ability… more
    Florida Health Care Plans, Inc. (08/21/25)
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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 ... Office-Bay **Position Overview:** This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM 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 ... overall provider documentation as it pertains to coding and risk adjustment guidelines. Reviews medical ...experience, . **Preferred Qualifications:** 1. Associate's degree. 2. Certified Risk Adjustment Coder (CRC) highly… more
    Tufts Medicine (08/21/25)
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  • Director Risk Adjustment , Coding…

    Highmark Health (Pittsburgh, PA)
    …Production Coding: Manage a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track production coding results ... Assurance on RPM Programs coding results: Lead team of coder / clinicians to review member medical records...Professional Coder (CPC) **Preferred** + AAPC, Certified Risk Adjustment Coder (CRC) **SKILLS**… more
    Highmark Health (08/08/25)
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