• Medicare Risk Adjustment

    Insight Global (Campbell, CA)
    …https://insightglobal.com/workforce-privacy-policy/. Skills and Requirements -5+ years of experience as a risk adjustment coder , CRC -Must have active ... Job Description As an HCC Medical Coder , your primary responsibilities will revolve around ensuring accurate and compliant coding practices. You'll need to maintain… more
    Insight Global (12/16/25)
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  • Risk Adjustment Medical Record…

    BlueCross BlueShield of Tennessee (Chattanooga, TN)
    …hours per week in accordance with BCBST policy\. **Preferred Qualifications:** + CRC \(Certified Risk Adjustment Coder \) certification is a plus\. If not ... from AHIMA or AAPC \(CPC, CCS, RHIT, RHIA\)\. + Must acquire the Certified Risk Adjustment Coder \(CRC\) certificate from AAPCwithin one year, after… more
    BlueCross BlueShield of Tennessee (12/10/25)
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  • Medical Coder I, Amazon One Medical Senior…

    Amazon (IL)
    …* 2+ years as a Profee Coder in an office setting inclusive of risk adjustment coder experience required * 1+ year experience in Medicare ... ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and CMS Risk Adjustment guidance. Assign appropriate ICD-10-CM, CPT,...requests in a timely manner. Work collaboratively with the Medicare Risk Operations team to ensure positive… more
    Amazon (10/31/25)
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  • Senior Coder - RCO Coding

    UTMB Health (Galveston, TX)
    Coder - Apprentice American Academy of Professional Coders (AAPC) Or CRC - Cert Risk Adjustment Coder American Academy of Professional Coders (AAPC) *One ... Senior Coder - RCO Coding **Galveston, Texas, United States**...plus. **Preferred Qualifications:** PB/HB, Revenue Cycle, Coding, Charge Capture, Medicare , CMS preferred. **LICENSES, REGISTRATIONS OR CERTIFICATIONS** CCA -… more
    UTMB Health (11/21/25)
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  • Health Care Disputes - Compliance Risk

    Ankura (New York, NY)
    …master's degree from an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either ... as knowledge of Risk Adjustment coding requirements preferably with a Risk Adjustment Coder certification. For individuals assigned and/or hired to… more
    Ankura (12/09/25)
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  • Risk Adjustment QA Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …focus on Medicare Advantage and ACA risk adjustment . * Certified Risk Adjustment Coder (CRC) certification * In-depth knowledge of ACA & ... Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance, and billing practices. * Proficiency in Excel and… more
    Blue Cross and Blue Shield of Minnesota (12/10/25)
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  • Risk Adjustment Coding Specialist…

    Trinity Health (Albany, NY)
    … and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** **. Certified Risk Adjustment Coder (CRC) required** . Excellent verbal and ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote… more
    Trinity Health (12/12/25)
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  • Certified Professional Medical Coder

    Henry Ford Health System (Troy, MI)
    …billing and third-party payer regulations. + Knowledge of CMS programs, processes, risk adjustment payment methodology, and payment principles. + Knowledge of ... deletions of codes, use of modifiers, and revenue codes to be compliant with Medicare rules and regulations, the Medicare Billing Manual, the American Medical… more
    Henry Ford Health System (11/14/25)
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  • Quality & Risk Adjustment Provider…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …or leadership-facing experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment Coder (CRC via AAPC) or Certified Professional ... and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid |...Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay Range: $88,600.00… more
    Blue Cross and Blue Shield of Minnesota (09/30/25)
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  • Senior Coding Educator

    Humana (Salt Lake City, UT)
    …to adapt quickly to change **Preferred Qualifications** + Bachelor's Degree + Certified Risk Adjustment Coder (CRC) + Certified Documentation Expert ... improvement opportunities and give guidance around operational and clinical best practices in the risk adjustment methodology. This role reports to the Risk more
    Humana (12/04/25)
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  • Medical Coding Educator

    Humana (Fort Lauderdale, FL)
    …interpreting large data sets **Preferred Qualifications** + Bachelor's Degree + CRC -Certified Risk Adjustment Coder + Experience interacting with healthcare ... **Required Qualifications** + AHIMA or AAPC CPC (Certified Professional Coder ) Certification + 4 or more years of medical...public speaking and presentation skills with healthcare providers + Medicare Risk Adjustment knowledge **Additional… more
    Humana (12/09/25)
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  • Clinical Documentation Improvement Specialist…

    Bluestone Physician Services (Stillwater, MN)
    …+ Bachelor's degree in Health Information Management, Nursing, or related field. + Certified Risk Adjustment Coder (CRC) certification, Risk ... thorough patient chart reviews to identify opportunities for providers to capture risk adjustment diagnostic codes accurately. The successful candidate will play… more
    Bluestone Physician Services (10/19/25)
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  • Government Programs Clinical Coordinator, Senior

    Blue KC (Kansas City, MO)
    …groups. + Analyze data and monitor provider metrics to identify risk adjustment , HEDIS or educational opportunities for the Medicare Advantage and Qualified ... business. + Develop educational tools for network providers regarding risk adjustment and HEDIS documentation and coding...at least five years coding experience + Obtain Certified Risk Coder (CRC) within 1 year of… more
    Blue KC (11/01/25)
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  • Coding Data Quality Auditor

    CVS Health (Springfield, IL)
    Coder ) or CCS-P (Certified Coding Specialist-Physician) required. + CRC (Certified Risk Adjustment Coder ). + Computer proficiency including experience ... required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.… more
    CVS Health (12/16/25)
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  • Senior Coding Educator

    Humana (Jackson, MS)
    Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique education ... Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups....an impact** **Required Qualifications** + AAPC CPC (Certified Professional Coder ) Certification + 2 or more years of medical… more
    Humana (12/09/25)
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  • Compliance Auditor, MAPD

    UCLA Health (Los Angeles, CA)
    …and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk -based audits, ... more. * Design and improve audit toolkits based on Medicare Advantage and Part D risk areas....a related field and/or equivalent experience. + Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), highly desired.… more
    UCLA Health (12/12/25)
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  • Manager Reimbursement Services (CPC, CRC,…

    Geisinger (Danville, PA)
    …Health Information Technician (RHIT) - American Health Information Management Association; Certified Risk Adjustment Coder - American Academy of Professional ... accurate predictive modeling is done by line of business ( Medicare versus Commercial). + Recommends reimbursement opportunities by utilizing...Coders (AAPC); Certified Professional Coder - American Academy of Professional Coders (AAPC) OUR… more
    Geisinger (10/31/25)
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