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Remote Flexible Risk Adjustment Coder Jobs in California

Humana

Medical Coder

Vacaville, CA · On-site +1

$21.25 - $28.25/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Vacaville, CA · On-site +1

$21.25 - $28.25/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Vacaville, CA · On-site +1

$21.25 - $28.25/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Molina Healthcare

VP, Risk Adjustment

Long Beach, CA · On-site +1

$137K - $184K/yr

Drives organizational risk adjustment policy, program standards, and performance, and maintains ... Oversees coding quality evaluation processes, ensuring accuracy, consistency, and compliance with ...

Urrly

Telehealth Nurse Practitioner

Los Angeles, CA · Remote

$600 - $720/day

CA Remote (no travel) * $600-$720/day (1099) * Minimum 24 hrs/week Flexible schedule * Own your ... Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ...

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Remote Flexible Risk Adjustment Coder information

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

To thrive as a Remote Flexible Risk Adjustment Coder, you need a strong grasp of medical coding standards (ICD-10-CM), risk adjustment models, and a certification such as CPC, CRC, or CCS. Proficiency with coding software, EHR systems, and secure remote communication tools is typically required. Attention to detail, time management, and strong analytical and communication skills help ensure accuracy and effective remote collaboration. These skills are vital for precise coding, regulatory compliance, and supporting accurate healthcare reimbursements in a remote work environment.

What is the difference between Remote Flexible Risk Adjustment Coder vs Remote Risk Adjustment Coder?

AspectRemote Flexible Risk Adjustment CoderRemote Risk Adjustment Coder
CertificationsAHIMA or AAPC certifications, CPC or CCSSame certifications as flexible role
Work EnvironmentFlexible hours, remote workPrimarily remote, with some flexibility
Employer UsageHealth plans, insurance companies, healthcare providersSimilar employer types, often overlapping
Search IntentFlexible scheduling, remote work optionsGeneral risk adjustment coding roles

The Remote Flexible Risk Adjustment Coder offers more scheduling flexibility compared to the standard Remote Risk Adjustment Coder, while both roles require similar credentials and are used in comparable healthcare settings. The flexible role is ideal for those seeking adaptable hours within the same industry.

How does a Remote Flexible Risk Adjustment Coder typically collaborate with healthcare providers and other coding professionals?

As a Remote Flexible Risk Adjustment Coder, collaboration often occurs through secure digital platforms, regular virtual meetings, and shared documentation tools. You may work closely with healthcare providers to clarify medical records and ensure coding accuracy, as well as coordinate with other coders to maintain consistency and compliance. Strong communication skills and responsiveness are essential, as much of the interaction is asynchronous and relies on clear documentation. This teamwork helps ensure accurate risk adjustment coding, supporting healthcare organizations in meeting regulatory and reimbursement standards.

What is a Remote Flexible Risk Adjustment Coder?

A Remote Flexible Risk Adjustment Coder is a healthcare professional who reviews and assigns diagnostic codes to patient records from a remote location, often with flexible hours. Their main role is to ensure that medical diagnoses are accurately captured for risk adjustment purposes, which helps healthcare organizations receive appropriate reimbursement from insurers. They typically analyze electronic health records, identify relevant conditions, and code them based on established guidelines. This job requires knowledge of medical terminology, coding systems like ICD-10, and a strong attention to detail. Working remotely allows for a flexible schedule, making it a popular option for experienced coders.
What are popular job titles related to Remote Flexible Risk Adjustment Coder jobs in California? For Remote Flexible Risk Adjustment Coder jobs in California, the most frequently searched job titles are:
What job categories do people searching Remote Flexible Risk Adjustment Coder jobs in California look for? The top searched job categories for Remote Flexible Risk Adjustment Coder jobs in California are:
Remote Flexible Risk Adjustment Coder jobs near you
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • Remote

$42.79 - $48.75/hr

Other

Posted 13 days 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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