ZipRecruiter

Log In

1

Crc Risk Adjustment Coder Jobs in New York (NOW HIRING)

Healthfirst (New York)

Hybrid Coding Educator

New York, NY · On-site

$29.75 - $34/hr

Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ... CPC and CRC (If no CRC, then it must be obtained within the first 6 months of employment) Preferred ...

Stanford Health Care

Physician Educator III

Newark, NJ · On-site

$44.13 - $57.36/hr

CRC - Certified Risk Adjustment Coder and * CPC - Certified Professional Coder or * CCS - Certified Coding Specialist Physical Demands and Work Conditions Physical Demands * Constant Sitting.

Oscar Health

Senior Data Scientist

New York, NY · Hybrid

$163K - $215K/yr

The Risk Adjustment Data Science team turns that data into the models, pipelines, and systems that ... code review, and testing Bonus points: * Advanced degree in a quantitative or technical field

previous pagenext page

Showing results 21-40

All JobsCrc Risk Adjustment Coder JobsCrc Risk Adjustment Coder Jobs in New York

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.

What are popular job titles related to Crc Risk Adjustment Coder jobs in New York?

For Crc Risk Adjustment Coder jobs in New York, the most frequently searched job titles are:

What job categories do people searching Crc Risk Adjustment Coder jobs in New York look for?

The top searched job categories for Crc Risk Adjustment Coder jobs in New York are:

What cities in New York are hiring for Crc Risk Adjustment Coder jobs?

Cities in New York with the most Crc Risk Adjustment Coder job openings:

Crc Risk Adjustment Coder jobs near you

Director of Coding Compliance

Essen Medical Associates

Bronx, NY • On-site

Full-time

Re-posted 15 days ago

Essen Health Care rating

4.6

Company rating: 4.6 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Overview

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state's most vulnerable and underserved residents.

Founded in 1999, we've grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women's health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We're looking for talented, motivated individuals to join our growing team. Whether you're a medical provider, administrator, or operations professional, there's a career here for you. Join us in making a real difference in the health of our community.

Job Summary

Position Title: Director of CodingCompliance

Position Summary: The Director of Coding Compliance is responsible for leading coding compliance and audit activities related to health plan operations, risk adjustment, payer audits and regulatory requirements. This role ensures accurate medical coding, documentation integrity, and adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess advanced CPC coding expertise, strong analytical skills, and extensive experience supporting compliance initiatives within a managed care or health plan environment.

Responsibilities

Key Responsibilities

  • Conduct complex coding audits and documentation reviews for accuracy, completeness, and regulatory compliance.
  • Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer guidelines.
  • Identify coding trends, compliance risks, and opportunities for operational improvement.
  • Partner with Compliance, SIU, Clinical Operations, Provider Education, and RCM teams to support organizational initiatives.
  • Develop and deliver provider and staff education related to coding accuracy and compliance standards.
  • Monitor regulatory changes and communicate impacts to leadership and operational teams.
  • Assist with internal and external audit preparation, corrective action plans, and regulatory responses.
  • Support oversight activities related to FWA (Fraud, Waste, and Abuse) prevention and documentation integrity.
  • Analyze audit findings and prepare detailed reports, dashboards, and executive summaries.
  • Serve as a subject matter expert for coding compliance and regulatory requirements.
Qualifications

Required Qualifications

  • Certified Professional Coder (CPC) certification required.
  • Minimum 7-10 years of medical coding and compliance auditing experience.
  • Minimum 5 years of experience within a health plan, managed care organization, or payer environment.
  • Strong knowledge of CMS regulations, Medicare Advantage, NYS Medicaid, HEDIS, and risk adjustment methodologies.
  • Extensive experience with ICD-10-CM, CPT, and HCPCS coding systems.
  • Knowledge of healthcare compliance standards and regulatory requirements.
  • Experience conducting coding audits and developing corrective action plans.
  • Strong analytical, communication, and leadership skills.
  • Proficiency with coding and audit software applications and Microsoft Office Suite.

 

Preferred Qualifications

  • CRC, CPMA, CCS, or other advanced coding/audit certification preferred.
  • Experience supporting delegated vendor oversight and regulatory audits.
  • Knowledge of NCQA standards and healthcare quality programs.
  • Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, or related field preferred.

 

Core Competencies

  • Regulatory Compliance
  • Risk Assessment
  • Medical Coding Expertise
  • Audit & Monitoring
  • Provider Education
  • Cross-Functional Collaboration
  • Strategic Problem Solving
  • Data Analysis & Reporting

 

Work Environment

  • Onsite - Bronx, New York Office Monday - Friday
Equal Opportunity EmployerEssen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse populationEmployment Type: FULL_TIME

What Essen Health Care employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply