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Crc Risk Adjustment Coder Jobs in Delaware (NOW HIRING)

Phpmcs

$200 - $220/hr

PHPprime provides wrap‑around services to help make our practice successful, including care coordination, practice transformation coaching, risk adjustment coding education, population health ...

M&T Bank

Senior Application Security Engineer

Wilmington, DE · On-site

$57 - $76.25/hr

Partner with engineering teams during code reviews to identify potential security vulnerabilities ... Identify risk-related issues needing escalation to management. * Promote an environment that ...

Liquid Personnel

Respond to referrals and complete timely risk assessments * Liaise with families, schools, and ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

Conduct initial assessments to determine risk levels and service eligibility. * Make decisions on ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

Conduct initial assessments to determine risk levels and service eligibility. * Make decisions on ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

Conduct initial assessments to determine risk levels and service eligibility. * Make decisions on ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

Conduct initial assessments to determine risk levels and service eligibility. * Make decisions on ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

Carry out risk assessments and safeguarding enquiries, ensuring statutory responsibilities are met ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

The ability to analyze complex information and identify necessary actions to mitigate risk to ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

GE Aerospace

Machinist - 2nd shift

Newark, DE · On-site

$20.25 - $27.50/hr

Blueprint, GD&T interpretation, understanding of G code: Read and interpret routers, engineering ... This role may encounter high risk or hazardous operations and/or include working shifts beyond a ...

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Crc Risk Adjustment Coder information

What is the difference between Crc Risk Adjustment Coder vs Medical Coder?

AspectCrc Risk Adjustment CoderMedical Coder
CertificationsCPMA, CPC, or RHIT/RHIA often preferredCPC, CCS, or CPC-H
Work EnvironmentHealthcare facilities, insurance companies, risk adjustment teamsHospitals, clinics, physician offices
Industry UsageRisk adjustment, Medicare Advantage, health plansMedical billing, coding, documentation

The Crc Risk Adjustment Coder specializes in coding for risk adjustment programs, focusing on accurate documentation for insurance and Medicare plans. Medical Coders handle a broader range of medical records and billing tasks across various healthcare settings. While both roles require coding certifications, Crc Risk Adjustment Coders focus more on risk and reimbursement accuracy within insurance programs.

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Crc Risk Adjustment Coder jobs near you

Certified Professional Coder

Regional Medical Management Services LLC

Wilmington, DE • On-site

$22 - $28/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted yesterday

Job description

  • Position Summary

    • The Certified Orthopedic Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for orthopedic-related diagnoses, procedures, and services. This role requires deep knowledge of musculoskeletal anatomy, surgical techniques, and orthopedic subspecialties to ensure compliant coding, optimal reimbursement, and adherence to payer and regulatory guidelines. The coder works closely with physicians, clinical staff, and billing teams to support clean claims, audit readiness, and revenue integrity.

  • Key Responsibilities
  • Coding & Documentation
  • Assign accurate ICD10CM, CPT, and HCPCS codes for orthopedic outpatient, inpatient, and surgical services
  • Code complex orthopedic procedures including:

    • ~Joint replacements

    ~Arthroscopy

    ~Spine procedures

    ~Fracture care

    ~Sports medicine procedures

  • Ensure coding reflects correct laterality, encounter type, global periods, and modifiers (e.g., 26, TC, 50, 59, LT/RT)
  • Compliance & Quality
  • Maintain compliance with CMS, AMA, payerspecific, and regulatory coding guidelines
  • Participate in internal and external audits; address findings and implement corrective actions
  • Stay current with annual coding updates, NCCI edits, LCDs/NCDs, and orthopedic coding trends
  • Identify documentation gaps and proactively query providers when clarification is needed
  • Collaboration & Support
  • Work closely with orthopedic surgeons, APPs, and clinical teams to improve documentation quality
  • Support billing and denial management teams by providing coding clarification and appeal support
  • Contribute to process improvement initiatives focused on accuracy, efficiency, and compliance
  • Productivity & Reporting
  • Meet or exceed established productivity and accuracy benchmarks
  • Track and report coding issues, trends, and opportunities for improvement
  • Assist with onboarding and mentoring junior coders as needed
  • Required Qualifications
  • Education & Certification

    • ~High school diploma or equivalent required

    ~Active coding certification, such as:

    CPC (AAPC)

    CCS (AHIMA)

    ~Orthopedic coding specialty certification preferred (e.g., COSC)

  • Experience

    • ~Minimum 2–3 years of orthopedic-specific coding experience

    ~Demonstrated experience coding operative reports and complex orthopedic cases

    ~Experience with EHR and practice management systems

  • Preferred Qualifications

    • ~Experience in high-volume orthopedic or multispecialty practices

    ~Knowledge of both professional and facility coding

    ~Prior audit or compliance experience

    ~Familiarity with value-based care and risk adjustment principles

  • Skills & Competencies

    • ~Advanced knowledge of musculoskeletal anatomy and orthopedic procedures

    ~Strong attention to detail with high accuracy standards

    ~Analytical mindset with the ability to interpret complex clinical documentation

    ~Excellent written and verbal communication skills

    ~Ability to work independently while collaborating across departments

    ~Strong time management and organizational skills

  • Work Environment
  • Officebased
  • Prolonged periods of computerbased work
  • Fastpaced, deadlinedriven environment requiring sustained accuracy
  • Performance Metrics
  • Coding accuracy rate
  • Productivity benchmarks
  • Audit outcomes
  • Denial reduction and clean claim rates
  • Benefits
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Dependent care flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

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