Houston, TX · On-site
$27.69 - $34.62/hr
Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and attending REGTAP calls. Stay current with coding standards, risk adjustment methodologies, and CMS ...
Houston, TX · On-site
$27.69 - $34.62/hr
Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and attending REGTAP calls. Stay current with coding standards, risk adjustment methodologies, and CMS ...
Houston, TX · On-site
$27.69 - $34.61/hr
About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and ...
Houston, TX · On-site
$27.69 - $34.61/hr
About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and ...
Houston, TX · On-site
$27.69 - $34.61/hr
About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and ...
Houston, TX · On-site
$27.69 - $34.61/hr
About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO ... Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and ...
Manager of Risk Adjustment Upward Health is an in-home, multidisciplinary medical group providing ... and coding opportunities across the enterprise. The Manager of Risk Adjustment is primarily ...
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Manager of Risk Adjustment Upward Health is an in-home, multidisciplinary medical group providing ... and coding opportunities across the enterprise. The Manager of Risk Adjustment is primarily ...
Houston, TX · On-site
$21.50 - $29.25/hr
Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) ...
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Houston, TX · On-site
$21.50 - $29.25/hr
Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) ...
Houston, TX · On-site
$21.50 - $29.25/hr
Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) ...
Houston, TX · On-site
$21.50 - $29.25/hr
Certified Risk Adjustment Coder (CRC) * Certified Coding Specialist (CCS) * Registered Health Information Technician (RHIT) * Registered Health Information Administrator (RHIA) * Minimum of three (3) ...
$25.30 - $35.74/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
$25.30 - $35.74/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
Houston, TX · On-site
$18 - $23.75/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
Houston, TX · On-site
$18 - $23.75/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
Houston, TX · On-site +1
$25.30 - $35.74/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
Houston, TX · On-site +1
$25.30 - $35.74/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
$25.30 - $35.74/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
$25.30 - $35.74/hr
... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...
Galveston, TX · Remote
$17.50 - $23.50/hr
RHIA - Registered Health Information Administrator (AHIMA) or * RHIT - Registered Health ... CRC - Certified Risk Adjustment Coder (AAPC) JOB SUMMARY: Properly codes and/or audits professional ...
Galveston, TX · Remote
$17.50 - $23.50/hr
RHIA - Registered Health Information Administrator (AHIMA) or * RHIT - Registered Health ... CRC - Certified Risk Adjustment Coder (AAPC) JOB SUMMARY: Properly codes and/or audits professional ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Dayton, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities ... Drives value-based care strategies through risk adjustment and quality improvement activities.
Dayton, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities ... Drives value-based care strategies through risk adjustment and quality improvement activities.
... risk adjustment, population health analytics, and practice operations--empowering primary care ... Required Credentials (One or More) • Certified Risk Adjustment Coder (CRC) -- demonstrates ...
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... risk adjustment, population health analytics, and practice operations--empowering primary care ... Required Credentials (One or More) • Certified Risk Adjustment Coder (CRC) -- demonstrates ...
... risk adjustment, population health analytics, and practice operations--empowering primary care ... Required Credentials (One or More) • Certified Risk Adjustment Coder (CRC) -- demonstrates ...
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... risk adjustment, population health analytics, and practice operations--empowering primary care ... Required Credentials (One or More) • Certified Risk Adjustment Coder (CRC) -- demonstrates ...
CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC) * RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA) * RHIT ...
CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC) * RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA) * RHIT ...
... risk adjustment, population health analytics, and practice operations-empowering primary care ... Required Credentials (One or More) • Certified Risk Adjustment Coder (CRC) - demonstrates ...
... risk adjustment, population health analytics, and practice operations-empowering primary care ... Required Credentials (One or More) • Certified Risk Adjustment Coder (CRC) - demonstrates ...
CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC) * RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA) * RHIT ...
CRC - Cert Risk Adjustment Coder by the American Academy of Professional Coders (AAPC) * RHIA - Cert-Reg Health Inform. Admins by the American Health Information Management Association (AHIMA) * RHIT ...
Pearland, TX · On-site
$159K - $273K/yr
... healthcare economics, risk adjustment, affordability (cost of care), payor performance and ... Experience within Optum, UnitedHealthcare, or similar managed care environment * Systems experience ...
Pearland, TX · On-site
$159K - $273K/yr
... healthcare economics, risk adjustment, affordability (cost of care), payor performance and ... Experience within Optum, UnitedHealthcare, or similar managed care environment * Systems experience ...
... healthcare economics, risk adjustment, affordability (cost of care), payor performance and ... Experience within Optum, UnitedHealthcare, or similar managed care environment * Systems experience ...
... healthcare economics, risk adjustment, affordability (cost of care), payor performance and ... Experience within Optum, UnitedHealthcare, or similar managed care environment * Systems experience ...
| Aspect | Internship Optum Health Coding Risk Adjustment | Medical Coding Specialist |
|---|---|---|
| Certifications | Typically none or basic coding certifications | Certified Professional Coder (CPC) or equivalent often required |
| Work Environment | Internship setting, training-focused, healthcare company | Healthcare facilities, outpatient clinics, or insurance companies |
| Employer & Industry | Optum Health, healthcare and insurance industry | Hospitals, clinics, insurance providers |
| Search & Comparison Intent | Entry-level, training, risk adjustment coding | Professional coding, billing, compliance |
Internship Optum Health Coding Risk Adjustment roles are typically entry-level, training-focused positions within Optum Health, emphasizing risk adjustment coding with minimal certifications. Medical Coding Specialists are more experienced professionals with certifications like CPC, working in healthcare facilities or insurance companies. The internship provides foundational exposure, while the specialist role involves independent coding and billing tasks.
$27.69 - $34.62/hr
Full-time
This job post has expired today. Applications are no longer accepted.
Job Number: 180041, Job Title: Risk Adjustment Coder II, Salary: $27.69 - $34.62 JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a patient's risk score, by mapping diagnoses to Hierarchical Condition Categories (HCCs) while adhering to CMS guidelines and internal coding policies for the following programs: including, but not limited to, Commercial Risk Adjustment, Medicare Risk Adjustment, and HHS and Medicare RADV (Risk Adjustment Data Validation). The Risk Adjustment Coder II will serve as a subject matter expert for risk adjustment and will assist in the development of team trainings, quality assurance audits, and collaborating with multiple departments across the organization. JOB SPECIFICATIONS AND CORE COMPETENCIES Provide advanced complex medical records reviews to identify and code all relevant diagnoses, including chronic conditions, utilizing ICD-10 coding guidelines for Commercial and Medicare risk adjustment programs. Conduct thorough clinical documentation review to ensure sufficient support and management for coded conditions. Identify opportunities to improve documentation and coding accuracy; provide analysis and recommendations for improvement to leadership. Consistently meet productivity and quality standards as outlined by supervisor. Ensure coding compliance by following the Official Coding Guidelines, HHS-RADV Protocols, and attending REGTAP calls. Stay current with coding standards, risk adjustment methodologies, and CMS Regulatory changes to ensure ongoing compliance and optimal coding practices. Actively contribute to achievement of departmental goals, as identified in Department's annual business plan, including specific departmental process improvement plans, and other duties as assigned. QUALIFICATIONS Education/Specialized Training/Licensure Bachelor's Degree or 5 or more years of experience in risk adjustment in lieu of degree in managed care organization required. AHIMA/AAPC Certified Coder, Medical Billing and Coding certification required (CPC, CRC, COC, CCS, CCS-P, or any combination of listed certifications) required. Associate or bachelor's degree preferred. Work Experience (Years and Area) 3-5 years' experience in Commercial or Medicare risk adjustment coding required. Clinical documentation improvement experience for inpatient and outpatient preferred. Experience within a managed care organization preferred. Management Experience (Years and Area) N/A Some management experience preferred. Software Proficiencies Microsoft 365 (Word, Excel, Outlook, SharePoint, Teams) Other Strong analytical skills Strong written and verbal skills Strong interpersonal skills Solid knowledge of ACA, Medicaid, and Medicare Risk Adjustment #J-18808-Ljbffr
Sourced by ZipRecruiter
Health care and social assistance
11 - 50 Employees
Washington, DC, US
1993
