Risk Adjustment Coder

About the role

It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Risk Adjustment Coder III is responsible for the accurate and timely assignment of medical diagnosis codes in accordance with established risk adjustment models, coding guidelines, and organizational standards. This role performs high-volume, production-based coding and chart review activities, following defined policies and procedures to ensure compliance and data accuracy. This position applies advanced coding knowledge but operates within established guidelines, with work subject to quality review and audit.

Responsibilities

• Medical Coding and Documentation: Assign ICD-10-CM diagnosis codes based on medical records, clinical documentation, and encounter data in accordance with established coding guidelines.
• Perform detailed chart reviews to ensure accurate capture of diagnoses, including HCC codes, following risk adjustment requirements.
• Identify and correct coding discrepancies based on documented evidence and coding standards.
• Maintain required productivity and quality benchmarks for coding volume and accuracy.
• Risk Adjustment Compliance: Apply CMS-HCC and other risk adjustment coding guidelines in daily work activities