Remote - HCC / Risk Adjustment Medical Coders

Key Responsibilities

• Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines
• Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines
• Validate and ensure the completeness, accuracy, and integrity of coded data
• Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding
• Stay up-to-date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding
• Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality
• Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries
• Participate in coding education and training programs to enhance coding skills and knowledge
• Prepare and submit reports related to coding activities, coding accuracy, and any coding-related issues or trends
• Assist in internal and external coding audits to ensure the quality and compliance of coding practices
• Identify opportunities for process improvement and efficiency in the coding process
• Offer suggestions to enhance coding documentation and accuracy

Requirements & Qualifications

• Minimum CPC or CCS certification from AHIMA or AAPC is required. Higher-level certifications such as CRC (Certified Risk Adjustment Coder) is a significant advantage.
• CPC-A (Apprentice) certification will not be considered for this position
• Minimum one to two years of experience in Risk Adjustment and HCC coding in a healthcare setting
• Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology
• Familiarity with electronic health record (EHR) systems and coding software
• Excellent attention to detail, analytical skills, and ability to work independently
• Strong communication and interpersonal skills for collaboration with medical professionals and team members
• Understanding of compliance and confidentiality regulations, including HIPAA