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Freelance Remote Risk Adjustment Coder Jobs in California

Molina Healthcare

Actuarial Analyst - REMOTE

Long Beach, CA · On-site +1

$77.97K - $117.81K/yr

Maintain risk adjustment model, estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources to identify risks. Additional leadership opportunities are ...

Urrly

Telehealth Nurse Practitioner

Los Angeles, CA · Remote

$600 - $720/day

Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ... Code with ICD-10 and CPT II * Deliver care plans and follow-up * Keep clean, audit-ready ...

Tendo

Principal Data Scientist

San Francisco, CA · On-site +1

$157.25K - $212.75K/yr

... and risk adjustment. The person in this role will access data from multiple sources (public and ... Hands-on experience writing Python code including, but not limited to, machine learning, data ...

Tendo

Senior Data Scientist

San Francisco, CA · On-site +1

$127.50K - $172.50K/yr

... and risk adjustment. The person in this role will access data from multiple sources (public and ... Hands-on experience writing Python code including, but not limited to, machine learning, data ...

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Freelance Remote Risk Adjustment Coder information

What are the key skills and qualifications needed to thrive as a Freelance Remote Risk Adjustment Coder, and why are they important?

Thriving as a Freelance Remote Risk Adjustment Coder requires deep knowledge of medical coding (especially ICD-10-CM), risk adjustment models, and compliance standards, typically verified by certifications like CRC, CPC, or CCS. Proficiency with coding software, EHR systems, and secure remote work platforms is essential for accurate and efficient coding. Strong attention to detail, self-motivation, and reliable communication are vital soft skills for managing independent workloads and collaborating with clients remotely. These abilities ensure accurate risk score calculations, regulatory compliance, and successful client relationships in a virtual work environment.

How do Freelance Remote Risk Adjustment Coders typically manage communication and workflow with healthcare clients and team members?

Freelance Remote Risk Adjustment Coders commonly use secure online platforms and project management tools to receive assignments, submit coded charts, and communicate with healthcare providers or project managers. Maintaining clear and prompt communication via email or dedicated messaging systems is crucial to clarify documentation, resolve coding queries, and ensure deadlines are met. Coders must be proactive in scheduling regular check-ins and staying updated on client-specific guidelines, as workflows can be fast-paced and require strong organizational skills. Collaboration often involves working independently but also participating in virtual meetings or training sessions to stay aligned with team quality standards.

What are Freelance Remote Risk Adjustment Coders?

Freelance Remote Risk Adjustment Coders are healthcare professionals who work independently from various locations to review medical records and assign codes that reflect patients’ health conditions and treatments, focusing on risk adjustment models. Their primary role is to ensure accuracy in coding so that healthcare organizations receive appropriate reimbursement and maintain compliance with regulatory standards. These coders typically work on a contract basis, using secure digital platforms to access records and submit their coding work. They must be highly knowledgeable in ICD-10-CM coding guidelines, risk adjustment methodologies (such as HCC), and HIPAA regulations.
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Freelance Remote Risk Adjustment Coder jobs near you
Senior Specialist, Provider Engagement- Quality HEDIS Risk (Remote)

Senior Specialist, Provider Engagement- Quality HEDIS Risk (Remote)

Molina Healthcare

Long Beach, CA • Remote

Full-time

Posted 19 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

146th of 259 rated insurance

Job description

Job Description


Job Summary

The Sr Specialist, Provider Engagement role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities.  Ensures the core set of Tier 2 providers in the Health Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using standard tools, facilitates data exchanges, and supports training and problem resolution for the Provider Engagement team. Communicates effectively with healthcare professionals and maintains compliance with policies.

This position is focused on HEDIS, Risk Adjustment and Quality performance.  Please update your resume with any relevant experience for these qualifiers.  

Job Duties

Ensures assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals.
Drives provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution.
Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes.
Drives provider participation in Molina risk adjustment and quality efforts (e.g. Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal.
Tracks all engagement and training activities using standard Molina Provider Engagement tools to measure effectiveness both within and across Molina Health Plans.
Serves as a Provider Engagement subject matter expert; works collaboratively within the Health Plan and with shared service partners to ensure alignment to business goals.
Assist Provider Engagement Specialists with training and problem escalation.
Accountable for use of standard Molina Provider Engagement reports and training materials.
Facilitates connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities.
Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by Plan and Corporate policies.
Communicates comfortably and effectively with Physician Leaders, Providers, Practice Managers, Medical Assistants within assigned provider practices.
Maintains the highest level of compliance.
This position may require same day out of office travel approximately 0 - 80% of the time, depending upon location.

Job Qualifications


REQUIRED QUALIFICATIONS:

Bachelor's degree in Business, Healthcare, Nursing, or related field, or equivalent combination of education and relevant experience
Minimum 3 years of experience improving provider quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience
Experience with various managed healthcare provider compensation methodologies, including but not limited to: fee-for-service, value-based care, and capitation
Strong working knowledge of quality metrics and risk adjustment practices across all business lines
Demonstrates data analytic skills
Operational knowledge and experience with PowerPoint, Excel, and Visio
Effective communication skills
Strong leadership skills

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To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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