ICD Coding Quality Auditor - Risk Adjustment Expert
Internationalinsuranceprofessionals
CVS Health is seeking a detail‑oriented reviewer to perform quality audits of medical records coded for CMS risk adjustment. You will support ICD coding accuracy, mentor staff, and lead dispute resolution across teams to ensure regulatory compliance. The role emphasizes independent work and cross‑functional collaboration with policy and clinical staff, focusing on improving documentation quality and audit outcomes within a full‑time schedule. #J-18808-Ljbffr Internationalinsuranceprofessionals
- MissionHires is seeking a Clinical Coding Analyst to ensure accurate reimbursement and compliance... ...identifying opportunities and mitigating risks while adhering to Medicare regulations.... ...in inpatient coding and extensive ICD-10 CM/PCS knowledge. A flexible schedule is...RiskRemote jobFlexible hours
$21.1 - $44.99 per hour
...prioritize safety and quality in everything we... ...medical records coded by internal team (... ...CDQA) to ensure the ICD-10 codes that are... ...the purpose of risk adjustment processes are appropriate... ...subject matter expert to vendors,... ...Professional Medical Auditor), CDEO (Certified...RiskHourly payFull timeTemporary workWork at officeLocal area$65 per hour
...Position: Certified Medical Coder (ICD-10) — Multilingual Clinical... ...accuracy, completeness, and coding integrity. Evaluate AI-... ...codes. Contribute expert input on annotation guidelines... .... Experience with HCC or risk-adjustment coding. Prior AI/ML annotation...RiskRemote jobContract workWork experience placementSummer work10 hours per weekFlexible hours$134.6k - $230.8k
...seeking an Executive Director of Risk Adjustment join our team in New York, NY... ..., clinical leadership, coding teams, and enterprise stakeholders... ...Ensure adherence to ICD-10, CMS-HCC, and state-specific... ...documentation processes Coordinate with Quality teams to align provider...RiskMinimum wageFull timeWork experience placementLocal areaWork from home$33.88 - $42.35 per hour
...collects, assesses, monitors and documents ICD-10 diagnoses based coding information as it pertains to CMS... ...in and supports the Medicare Risk Adjustment team-based environment to educate providers... ...building a model of care focused on quality and health outcomes. Works...RiskContract workWork experience placementFlexible hours- Practice Resources LLC, a multi-specialty practice management company, seeks an experienced Risk Adjustment Medical Coder for a fully remote role. You will validate CPT/diagnosis codes, code for HCCs, and ensure CMS guidelines are met. Ideal candidates hold CCS/CPC, CRC is...RiskRemote jobFlexible hours
- ...platform trusted for healthcare, is seeking a Client Coding Project Manager to oversee risk adjustment coding audits and QA programs. You will work with management to set benchmarks, educate teams, and drive quality improvements across internal and vendor teams. The role...Risk
- ...outside of NCAL.Support Health Plan Risk Adjustment operations through government... ...compliance oversight, and internal quality assurance reviews. Perform coding validation, documentation review,... ...serving as a compliance subject matter expert related to coding functions within...RiskWork experience placement
- Alignment Health is seeking an experienced HCC Coding Analyst to interface with provider partners, audit RAPS submissions, and ensure CMS data accuracy in risk adjustment initiatives. The role requires 3+ years in medical coding, certification, and experience with CMS guidelines...Risk
- ...role focuses on in-depth review of outpatient CPT, HCPCS, and ICD-10 codes to resolve errors and improve claims accuracy. Strong knowledge... ...pay ranges aligned to UC San Diego Health salary scales and emphasizes high-quality patient care and #J-18808-Ljbffr UC San DiegoRemote job
- Optum is seeking a Coder II to join our Health Information Management team. This role focuses on accurate coding of diagnoses and procedures (ICD-10-CM, CPT) to support data analytics and claims processing, with telecommute options from anywhere in the United States. Required...Remote job
- Ovation Healthcare seeks an Emergency Department Coder to code and abstract diagnoses and charges from ED medical records for optimal reimbursement... ..., and adherence to coding guidelines. You will assign ICD-10-CM and CPT/HCPCS codes, review records for accuracy, and...Remote job
- Gebbs Healthcare Solutions Inc seeks a Professional Coder to accurately assign ICD-10-CM, CPT, HCPCS Level II codes and modifiers for outpatient professional services. You will review documentation to support accurate coding, ensure compliance with guidelines, and help...Monday to FridayFlexible hours
$84 per hour
...procedures, severity of illness, and risk of mortality accurately.... ...accuracy. Collaborate with coding, compliance, and clinical... ...methodology, CC/MCC hierarchies, and ICD-10-CM/PCS coding guidelines.... ...Experience with HCC risk adjustment and outpatient CDI programs....RiskRemote jobContract workSummer work- Tier4 Group is seeking an Experienced Risk Adjustment Coder with Medicare Advantage and ACA coding expertise to support risk adjustment initiatives, medical record... ...supervision. The candidate will review records, assign ICD-10-CM codes for MA/ACA programs, perform audits,...RiskRemote job
- Oscar Health is seeking an Associate, Risk Adjustment Auditor to conduct internal and external quality audits of ICD-10 code abstraction and collaborate with management on benchmarks and quality assurance programs. Responsibilities include medical record reviews, reporting...Risk
- ...2026-10-07The Senior Risk Adjustment Coder is responsible for... ...risk adjustment coding through retrospective... ...compliance with CMS, ICD-10-CM, and organizational... ...accuracy, documentation quality, and program performanceServe... ...as subject matter expert on PBACO risk...RiskWork at officeRemote work
- ...Albany Med Health System is seeking an Inpatient Hospital Coder to apply ICD-10-CM/PCS coding for inpatient services. This fully remote role requires 2+ years inpatient coding experience and AHIMA/AAPC certification preferred. Responsibilities include accurate coding...Remote workRelocationFlexible hours
- Memorial Hermann Health System is seeking a Coding Specialist responsible for inpatient coding, reviewing medical records, and assigning ICD-10-CM/PCS codes to support reimbursement, research, and regulatory compliance. This remote role requires meeting the stated qualifications...Remote job
- A health care organization is seeking a Coding Specialist to ensure accurate coding for patient records. The role requires experience in CPT and ICD-10-CM coding along with AAPC CPC certification. Responsibilities include conducting coding reviews, resolving denials, and...Remote jobFull time
- Insight Global is seeking an experienced HCC Risk Adjustment Coder for a fully remote, high-volume Medicare project. This 5-month contract... .... Applicants should have 2+ years in risk adjustment coding, strong ICD-10 knowledge, and an active CPC (AAPC) or CCS (AHIMA)...RiskRemote jobHourly payFull timeContract workFlexible hours
- ...Medical Coder for remote work. The role involves reviewing medical records, abstracting and codes clinical data such as diseases, operations, procedures, and therapies using CPT and ICD-10 coding standards. The ideal candidate has an associate degree or equivalent, 2–3...Remote work
- ...review medical records, identify diagnoses, and code them according to ICD-10-CM guidelines to support risk adjustment and payer reimbursement. Ideal candidates have... ...independently in a remote setting while delivering high-quality, accurate coding for multiple client projects....RiskRemote job
- ...Specialist to audit lab claim data, submit claims, and ensure accurate HCFA 1500 billing. The role requires familiarity with CPT/ICD-10 coding and payer guidelines and involves collaboration with the billing and compliance teams to meet end-of-month deadlines. The ideal...Remote jobWork at office
$58.66k - $81.68k
...office, out-patient, and inpatient physician coding. Provides education regarding documentation requirements for improved quality of coding and to ensure accurate and complete... ...information to clinical staff, including CPT and ICD-10 code changes, medical necessity policies,...TraineeshipWork at officeLocal area$25 - $26.7 per hour
...medical records to identify and code diagnoses using a... ...representation of patient conditions for risk adjustment and reimbursement purposes.... ...compliance with established ICD-10 CM, DRGs coding guidelines... ...environment while maintaining high quality. Must be able to follow...RiskRemote workFlexible hours$58.7k - $70.4k
Remote The Risk Adjustment Coding Analyst provides operational, analytical, and administrative support to business leaders and teams. You will... ...opportunities to improve manual work, strengthen data quality, enhance partner usability, and improve the clarity of deliverables...RiskFull timeWork at officeRemote workWork from homeHome office- The Associate, Risk Adjustment Auditor conducts internal and external quality audits specific to ICD-10 code abstraction. Work with management to implement benchmarks and quality assurance programs. Responsibilities: Perform medical record reviews and report ICD-10-CM diagnosis...RiskRemote jobWork experience placement
$27.02 - $48.55 per hour
...regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS... ...record documentation and appropriate coding. Assists in resolving... ...documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with...RiskHourly payFull timePart timeH1bWork at officeLocal areaRemote workFlexible hours- ...this role you will apply your coding and documentation expertise... ...Knowledge Contribution Contribute expert input on annotation... ...one of CCDS, CHC, CCS, or CPC ICD-10 coding experience Currently... ...Epic Experience with HCC or risk-adjustment coding Prior AI/ML annotation...RiskPart timeWork experience placementRemote work10 hours per weekFlexible hours
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