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Role Description Performs technical and administrative work reviewing, abstracting, and assigning accepted medical and surgical codes for inpatient and outpatient diagnoses, procedures, and services. Duties are performed in compliance with third party, state, and federal regulations according to standardized procedures. This position is eligible for the remote coding program. Qualifications - High school diploma or GED. - Successful completion of HIS Hospital Proficiency Test. - Must have AHIMA (American Health Information Management Association) certification and credential or AAPC (American Academy of Professional Coders) certification and credential. - Minimum of two years of coding experience. - Strong knowledge of ICD-10 CM/PCS and/or HCPCS/CPT coding with analytical and data mining skills. - Strong knowledge of coding rules and guidelines, Coding Clinic, and CPT Assistant. - Strong knowledge of Ambulatory Payment Classification (APC) system for outpatient cases and/or Medical Severity Diagnosis Related Groups (MS-DRG) system for inpatient cases. - Computer data entry skills required. - Possess balance or being highly productive and yet produce high quality work. - Strong communication skills, both written and verbal, and have extensive attention to detail. - Deliver outstanding customer service that upholds CarolinaEast's Standards of Excellence. Requirements - AHIMA or AAPC certification and credential. - Two years of coding experience. - Strong knowledge of coding systems and guidelines. - Computer data entry skills. - Strong communication skills. Benefits - Robust benefits package for full-time employees. - Benefits for part-time plus and part-time staff.

Title: Medical Records Coder III Outpatient (REMOTE) Business and Administrative Job Description: BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details: - Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) - Status: Full time (non-exempt) - Shift: 7:00 AM to 3:30 PM - Days: Monday through Friday The Medical Records Outpatient Coder III will work remotely on a full-time basis. Sign on bonuses available! Responsibilities: - The Medical Records Outpatient Coder III reviews short stay focused encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. - Works in conjunction with various departments for missing documentation and monitors bill hold reports. - Strong utilization of medical terminology and anatomy. - Assists Manager/Director with mentoring/training of Coder I and Coder II team members and clinical practice students from various colleges. - Performs other duties as assigned. Required Coding Experience: - Emergency room (ED) - Same day surgery (ambulatory) - Observation cases Why BayCare? Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence. Our team members focus on tomorrow by achieving personal and professional success today. That is why you will thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve. BayCare offers a competitive total reward package including: - Benefits (Health, Dental, Vision) - Paid time off - Tuition reimbursement - 401k match and additional yearly contribution - Yearly performance appraisals and team award bonus - Community discounts and more - AND the Chance to be part of an amazing team and a great place to work! Certifications and Licensures: - Required: Certified Coding Specialist (CCS) - Preferred: RHIT (Health Information) Education: - Required: high school or equivalent - Preferred: associate degree in Health Information Management Experience: - Required 5 years of Outpatient Facility Coding - Strong CPT coding Equal Opportunity Employer Veterans/Disabled

Role Description The Risk Adjustment Specialist – Coding Compliance supports the organization’s delegated Risk Adjustment and Coding Compliance programs by performing specialized audit support, documentation review coordination, coding validation support, medical record analysis, and compliance activities to promote accurate and complete Hierarchical Condition Category (HCC) capture in accordance with Centers for Medicare & Medicaid Services (CMS), California Department of Managed Health Care (DMHC), National Committee for Quality Assurance (NCQA), Office of Inspector General (OIG), and contracted health plan requirements. - Supports coding compliance oversight activities related to Medicare Advantage Risk Adjustment, Risk Adjustment Data Validation (RADV), provider documentation integrity, and coding accuracy initiatives. - Assists with identifying documentation gaps, monitoring coding compliance trends, coordinating audit preparation activities, and supporting provider education efforts to ensure accurate Risk Adjustment Factor (RAF) scoring and regulatory compliance. - Collaborates closely with Coding Compliance leadership, certified coders, providers, population health teams, utilization management, care management, quality improvement, and health plans to support compliant documentation and coding practices, audit readiness, and delegated risk adjustment program performance. Qualifications - Minimum: High school diploma or GED equivalent required. - Preferred: Associate’s degree or higher in healthcare administration, public health, social services, or related field. - Minimum: At least one year of experience in one or more of the following areas: risk adjustment, coding compliance, medical record review, managed care, healthcare administration, managed care or MSO environment, medical office or provider operations. - Preferred: Experience supporting Medicare Advantage Risk Adjustment programs. Experience supporting CMS RADV audits or coding compliance audits. Experience in an MSO, IPA, health plan, delegated entity, or managed care environment. Experience working with electronic health records, coding software, or Risk Adjustment platforms. - Certification(s): Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other coding certification preferred. - Knowledge of CMS Risk Adjustment methodology, HCC documentation requirements, and RAF score principles. - Understanding of Medicare Advantage Risk Adjustment, coding compliance, and documentation integrity requirements. - Familiarity with CMS RADV audit standards, DMHC regulatory requirements, NCQA standards, and delegated health plan oversight requirements. - Ability to identify documentation deficiencies, coding inconsistencies, compliance risks, and audit-related concerns. - Strong organizational, analytical, auditing, and data tracking skills with exceptional attention to detail and accuracy. - Ability to maintain accurate records, audit logs, compliance documentation, and reporting tools. - Proficiency with electronic health records, Risk Adjustment platforms, coding software, and Microsoft Office applications. - Strong verbal and written communication skills with the ability to communicate professionally with providers, coders, leadership, health plans, and interdisciplinary teams. - Ability to handle confidential and sensitive information in compliance with HIPAA and organizational policies. - Ability to manage multiple priorities, deadlines, and audit-related activities in a fast-paced managed care environment. - Ability to work independently while collaborating effectively within interdisciplinary operational and compliance teams. Requirements - The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. - Primarily sedentary work involving prolonged computer use. - Occasional standing, walking, and local travel may be required. - Ability to lift up to 20 pounds occasionally. - Requires strong attention to detail, data analysis capability, and effective communication skills. - Work is performed in an office or remote environment supporting electronic medical record and Risk Adjustment systems.