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North East Medical Services
2.8
HEALTH CODER - HCC & RISK ADJUSTMENT
Burlingame, CA
$42.79 - $48.75 Per Hour (Employer provided)
Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required. This is an FLSA Non-exempt position.…
30d+
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Virtix Health
2.1
HCC Coding Quality Specialist (Auditor)
Texas
Easy Apply
All HCC/Risk Adjustment auditors MUST be certified through either the AAPC or AHIMA. All auditors MUST be certified through either the AAPC or AHIMA.…
30d+
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FinThrive
2.8
AR Recovery/Healthcare Denials Analyst - Onsite: Plano, Texas
Plano, TX
Easy Apply
Strong *problem-solving and analytical skills* to assess insurance payment discrepancies. *Apply now* to make a real impact with FinThrive!…
2d
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Baptist Hospitals of Southeast Texas
3.1
Collector - Business Office - Days
Beaumont, TX
$38K - $56K (Glassdoor est.)
All collection follow up calls are made within the guidelines set by management until claim is paid or deemed uncollectible. High School diploma or equivalent.…
30d+
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Rite of Passage
2.7
Collections Specialist
Queen Creek, AZ
$38K - $50K (Glassdoor est.)
Easy Apply
Knowledge of multi-state Medicaid billing processes. Work aging reports and prioritize accounts based on timely filing limits and reimbursement impact.…
30d+
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ElevatePFS
3.1
Managed Care Appeals Analyst
Remote
$23.00 - $28.28 Per Hour (Employer provided)
Easy Apply
Associate or bachelor’s degree in Accounting, Finance, Business Administration, Healthcare Administration, or closely related field or in lieu of degree, four (……
30d+
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AHS Vista LLC
Clerk
Waukegan, IL
$20.00 - $22.00 Per Hour (Employer provided)
Easy Apply
Answer incoming calls and assist callers within scope of role. Basic computer proficiency and data entry skills. General Office Support (as assigned).…
24d
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Williamson Medical Center
3.8
Patient Account Rep II - PRN up to 24 hours- Follow Up with Payors
Franklin, TN
$37K - $48K (Glassdoor est.)
Easy Apply
Answers patient calls regarding billing and account balances for all Medicare/MCR Managed Care accounts. Requires sitting for prolonged periods of time, viewing……
25d
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MedLink Billing Solutions LLC
Revenue Cycle Specialist
Woodstock, VA
$33K - $37K (Employer provided)
Easy Apply
The ideal candidate will play a crucial role in managing the revenue cycle process, ensuring accurate medical, behavioral health and dental billing, coding, and……
9d
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Indian Health Service
3.5
Medical Records Technician (Coder)
Camp Verde, AZ
$50K - $66K (Employer provided)
If one of the documents is a state-issued ID or driver's license, it must be REAL ID-compliant. Individuals with substantial delinquent or unresolved financial……
17d
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US Department of Veterans Affairs
3.6
Medical Records Technician (Coder In/Out)
North Chicago, IL
$62K - $81K (Employer provided)
The training program must have led to eligibility for coding certification/certification examination, and the sponsoring academic institution must have been……
2d
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US Department of Veterans Affairs
3.6
Medical Reimbursement Technician
Leavenworth, KS
$41K - $60K (Employer provided)
HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees,……
17d
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North East Medical Services

2.8

HEALTH CODER - HCC & RISK ADJUSTMENT

Burlingame, CA

$42.79 - $48.75 Per Hour (Employer provided)

Is your resume a good match?

Use AI to find out how well the skills on your resume fit this job description.

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

HCC Coding and Risk Adjustment (RA) Program Support
- Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
- Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
- Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
Provider Training and Clinical Documentation Improvement (CDI)
Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
Data Analysis and Reporting
- Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
- Generate reports and dashboards to track coding performance and documentation accuracy.
- Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
Compliance and Continuous Improvement
- Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
- Assist in the development and implementation of internal coding policies and procedures.
- Participate in quality improvement initiatives related to coding and documentation.
- Performs other job duties as required by manager/supervisor

Education & Certification:
- BS/BA Degree in Health Science or General Education is required.
- Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
- Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
Experience:
- Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
- Experience in provider education, clinical documentation improvement (CDI), and chart audits.
- Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
Skills & Competencies:
- Excellent communication, presentation, and interpersonal skills.
- Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
- Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
- Proficiency in electronic health records (EHR) and coding software.
- Strong analytical and problem-solving skills.

LANGUAGE:

Must be able to fluently speak, read and write English.
Fluency in other languages is an asset.

STATUS:

This is an FLSA Non-exempt position.
This is not an OSHA high-risk position.
This a full-time position.

See company reviews

Base pay range

The minimum salary is $42.79 and the max salary is $48.75.

$42.79 – $48.75/hr (Employer provided)

$45.77

/hr Median

Burlingame, CA

If an employer includes a salary or salary range on their job, we display it as "Employer Provided". If a job has no salary data, Glassdoor displays a "Glassdoor Estimate" if available. To learn more about "Glassdoor Estimates," see our FAQ page.

Working here doesn’t have to be a secret

2.8

Recommend to a friend
Approve of CEO
CEO: Eddie Chan
31 Ratings

North East Medical Services

2.8

HEALTH CODER - HCC & RISK ADJUSTMENT

Burlingame, CA

$42.79 - $48.75 Per Hour (Employer provided)

North East Medical Services

2.8

HEALTH CODER - HCC & RISK ADJUSTMENT

Burlingame, CA

$42.79 - $48.75 Per Hour (Employer provided)

Is your resume a good match?

Use AI to find out how well the skills on your resume fit this job description.

ESSENTIAL JOB FUNCTIONS:

HCC Coding and Risk Adjustment (RA) Program Support
- Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
- Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
- Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
Provider Training and Clinical Documentation Improvement (CDI)
Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
Data Analysis and Reporting
- Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
- Generate reports and dashboards to track coding performance and documentation accuracy.
- Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
Compliance and Continuous Improvement
- Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
- Assist in the development and implementation of internal coding policies and procedures.
- Participate in quality improvement initiatives related to coding and documentation.
- Performs other job duties as required by manager/supervisor

Education & Certification:
- BS/BA Degree in Health Science or General Education is required.
- Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
- Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
Experience:
- Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
- Experience in provider education, clinical documentation improvement (CDI), and chart audits.
- Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
Skills & Competencies:
- Excellent communication, presentation, and interpersonal skills.
- Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
- Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
- Proficiency in electronic health records (EHR) and coding software.
- Strong analytical and problem-solving skills.

LANGUAGE:

Must be able to fluently speak, read and write English.
Fluency in other languages is an asset.

STATUS:

This is an FLSA Non-exempt position.
This is not an OSHA high-risk position.
This a full-time position.

See company reviews

Base pay range

The minimum salary is $42.79 and the max salary is $48.75.

$42.79 – $48.75/hr (Employer provided)

$45.77

/hr Median

Burlingame, CA

Working here doesn’t have to be a secret

2.8

Recommend to a friend
Approve of CEO
CEO: Eddie Chan
31 Ratings

Are you open to new opportunities?

17 Ra coder jobs in United States

Base pay range

Working here doesn’t have to be a secret

Base pay range

Working here doesn’t have to be a secret