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Freelance Remote Risk Adjustment Coder Jobs in California

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 ...

Astrana Health, Inc.

$33 - $38/hr

... payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do * Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ...

UST

Sales Director, Healthcare IT

Aliso Viejo, CA · Remote

$130K - $195K/yr

... risk adjustment leadership, or actuarial credential (ASA, FSA). * Financial modeling depth - TCO, NPV, sensitivity analysis. Compensation and Location Role Location: Remote Compensation Range: $130 ...

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Freelance Remote Risk Adjustment Coder information

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.

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.
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Freelance Remote Risk Adjustment Coder jobs near you
Risk & Quality Performance Manager (Remote)

Risk & Quality Performance Manager (Remote)

Molina Healthcare

Long Beach, CA • On-site, Remote

$66K - $129K/yr

Full-time

Re-posted 22 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

134th of 281 rated insurance

Job description


Job Description
Job Summary
The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.
Job Duties
• Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality rate trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors.
• Monitor projects from inception through successful delivery.
• Oversee Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data.
• Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
• Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
• Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
• Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
• Proactively communicate risks and issues to stakeholders and leadership.
• Create, review, and approve program documentation, including plans, reports, and records.
• Ensure documentation is updated and accessible to relevant parties.
• Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.
Job Qualifications
REQUIRED EDUCATION:
Bachelor's degree or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
• 2+ years of program and/or project management experience in risk adjustment and/or quality
• 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems
• 2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners
• Familiarity with running queries in Microsoft Azure or SQL server
• Healthcare experience and functional risk adjustment and/or quality knowledge
• Mastery of Microsoft Office Suite including Excel and Project
• Experience partnering with various levels of leadership across complex organizations
• Strong quantitative aptitude and problem solving skills
• Intellectual agility and ability to simplify and clearly communicate complex concepts
• Excellent verbal, written and presentation capabilities
• Energetic and collaborative
PREFERRED EDUCATION:
Graduate degree or equivalent combination of education and experience
PREFERRED EXPERIENCE:
• Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements
• Experience working in a cross-functional, highly matrixed organization
• SQL proficiency
• Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired
#PJCorp
#LI-AC1
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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