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Full Time R1 Rcm Medical Coding Jobs in California

NORTHEAST COMMUNITY CLINIC

HCC Coder

Alhambra, CA · On-site

$34 - $39/hr

Schedule: * Full-time (Non-Exempt) * Flexible, may require some evening and weekends Primary Duties ... Review of medical records to ensure accuracy and claims for proper documentation and coding and ...

Nexus HR

FQHC Billing Account Manager

Santa Fe Springs, CA · On-site

$28 - $30/hr

... RCM Billing Account Manager. The ideal candidate will have a strong background in FQHC medical billing, revenue cycle management, and coding compliance. This role requires deep knowledge of payer ...

Nexus HR

FQHC Billing Account Manager

Santa Fe Springs, CA · On-site

$30 - $34/hr

... RCM Billing Account Manager. The ideal candidate will have a strong background in FQHC medical billing, revenue cycle management, and coding compliance. This role requires deep knowledge of payer ...

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Full Time R1 Rcm Medical Coding information

What is a full time R1 RCM medical coder?

A Full Time R1 RCM Medical Coder is a professional employed by R1 RCM, a leading revenue cycle management company, who specializes in reviewing clinical documents and assigning standardized codes for diagnoses and procedures. These codes are essential for insurance billing, reimbursement, and maintaining accurate patient records. The position is full-time, meaning the individual works a standard number of hours per week, typically 40. Medical coders must be detail-oriented, knowledgeable about healthcare coding systems like ICD-10 and CPT, and adhere to regulations to ensure accurate billing and compliance.

What are the key skills and qualifications needed to thrive as a full time R1 RCM medical coder?

To thrive as a Full Time R1 RCM Medical Coder, you need a solid understanding of medical terminology, anatomy, and ICD-10/CPT coding systems, typically backed by a relevant certification such as CPC or CCS. Proficiency in medical coding software, electronic health records (EHRs), and revenue cycle management (RCM) platforms is essential. Attention to detail, analytical thinking, and strong communication skills help ensure coding accuracy and effective collaboration with healthcare teams. These skills are crucial for maximizing reimbursement, maintaining compliance, and supporting the financial health of healthcare organizations.

What types of medical records and specialties will I typically work with as a full time R1 RCM medical coder?

As a Full Time R1 RCM Medical Coding professional, you'll most often work with a variety of medical records, ranging from outpatient and inpatient charts to specialty-specific documentation such as radiology, cardiology, or surgery. The exact mix can depend on the client’s needs, but you can expect to code diagnoses, procedures, and treatments using ICD-10, CPT, and HCPCS codes. Collaborating closely with clinicians and billing teams is common to ensure accuracy and compliance. Staying updated on coding guidelines and payer requirements is also essential for success in this role.

What is the difference between Full Time R1 Rcm Medical Coding vs Full Time R1 Rcm Medical Billing?

AspectFull Time R1 Rcm Medical CodingFull Time R1 Rcm Medical Billing
Primary RoleAssigns medical codes based on clinical documentationProcesses and submits insurance claims for reimbursement
Required CertificationsCertified Professional Coder (CPC) or equivalentBilling and Coding certifications often preferred
Work EnvironmentTypically in healthcare facilities or remote coding centersOften in billing departments or remote billing offices
Industry UsageUsed across hospitals, clinics, and healthcare providersUsed mainly in insurance companies and healthcare providers

While both roles are essential in healthcare revenue cycle management, medical coders focus on translating clinical documentation into codes, whereas medical billers handle claims processing and reimbursement. Understanding these differences helps professionals choose the right career path or job focus within the healthcare industry.

What are the most commonly searched types of R1 Rcm Medical Coding jobs in California?

The most popular types of R1 Rcm Medical Coding jobs in California are:

What cities in California are hiring for Full Time R1 Rcm Medical Coding jobs?

Cities in California with the most Full Time R1 Rcm Medical Coding job openings:

Full Time R1 Rcm Medical Coding jobs near you

HEALTH CODER - HCC & RISK ADJUSTMENT

Burlingame, CA • Remote

NORTH EAST MEDICAL SERVICES
Health Care and Social Assistance • 51 - 200 employees
Learn more about NORTH EAST MEDICAL SERVICESexternal

$42.79 - $48.75/hr

Full-time

Re-posted 11 hours ago

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. 

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