Risk Adjustment Coder

AbroadWorks Inc.; Manila; Remote; PHP 433,000 - 692,000; Full time

Benefits offered by this job

Five paid vacation days per year

5% annual raise

15-minute break for every 4 hours

Healthcare benefits after 2 months

Job summary

AbroadWorks Inc. is seeking a certified Risk Adjustment Coder to review medical records, capture and validate diagnosis codes, and apply CMS HCC categories in a remote setup.

Ideal candidates have 2+ years in risk adjustment coding within managed care, strong ICD-10-CM knowledge, and HIPAA compliance. Candidates must have a stable internet connection and own device for remote work.

Qualifications

• Active professional coding certification through AHIMA or AAPC (CRC, CPC, or CCS-P).
• Minimum 2 years of risk adjustment coding experience in managed care.
• Strong knowledge of HCC models and CMS categories.
• Ability to code with ICD-10-CM without an encoder.
• Extensive knowledge of ICD-10-CM outpatient guidelines.
• Strong clinical knowledge of chronic illnesses.
• HIPAA compliance and confidentiality.
• Attention to detail with production and accuracy.
• Able to work independently with minimal supervision.
• Proficient in word processing and office software.
• Reliable internet and remote work setup.
• Must pass background verification.

Responsibilities

• Review records to ensure accurate capture of diagnoses.
• Assess codes for accuracy, completeness, and appropriateness.
• Apply CMS HCC categories to records.
• Code diagnoses using ICD-10-CM without an encoder.
• Maintain tracking tools for reviews.
• Meet production and accuracy metrics consistently.
• Provide feedback and correct discrepancies.
• Assist with training on coding practices.
• Maintain HIPAA compliance and data privacy.
• Organize coding-related documentation accurately.

Skills

Risk adjustment coding

CMS HCC knowledge

ICD-10-CM coding

HIPAA compliance

English communication

Attention to detail

Remote work discipline

Analytical skills

Education

AHIMA or AAPC certification (CRC/CPC/CCS-P)

Tools

ICD-10-CM coding manual

ICD-10-CM guidelines

Job description

About Us:

AbroadWorks is a fast growing global enterprise with established operations in the United States, India, and the Philippines. We specialize in providing both service-based solutions and advanced tech to help North American organizations in finding, onboarding, and managing global talent easily.

Our Offerings:

Global Staffing Services: Currently, the majority of our revenue is generated through our comprehensive global staffing services, which cater to the diverse needs of our clients.

Technology Solutions: Looking ahead, our strategic focus is to expand our footprint in the software sector, leveraging our technology to improve global human capital and talent management processes.

Job Title: Risk Adjustment Coder

Location:

Fully Remote, Philippines

Rate:

$5.00 - $8.00 per hour based on experience

Job Type

Full-Time

Job Description:

We are seeking a certified and experienced Risk Adjustment Coder to review medical records, accurately capture and validate diagnosis codes, and apply CMS HCC coding categories in accordance with established coding guidelines.

The ideal candidate has at least two years of certified risk adjustment coding experience, particularly within the managed care industry, and possesses strong clinical knowledge of chronic illnesses. This role requires exceptional attention to detail, analytical skills, coding accuracy, and the ability to consistently meet production and quality expectations while working independently in a remote environment.

Requirements:

• Active professional coding certification through AHIMA or AAPC, such as CRC, CPC, or CCS-P.
• Minimum of 2 years of experience as a certified coder in risk adjustment coding, with emphasis on the managed care industry.
• Strong knowledge of HCC coding models and CMS HCC categories.
• Ability to accurately code using an ICD-10-CM code book without an encoder.
• Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines.
• Strong clinical knowledge related to chronic illness diagnosis, treatment, and management.
• Thorough understanding of HIPAA requirements and commitment to maintaining the privacy and confidentiality of medical chart documentation.
• Strong analytical and problem-solving skills with exceptional attention to detail.
• Ability to consistently meet production, accuracy, and deadline requirements.
• Strong self-discipline and ability to work independently without direct supervision.
• Excellent computer and word processing skills.
• Advanced proficiency with software used for word processing, presentations, spreadsheets, calendaring, and other coding-related tasks.
• Reliable internet connection and professional remote work setup.

Responsibilities:

• Review medical records to ensure all appropriate diagnosis codes are accurately captured, documented, and corrected when necessary.
• Assess diagnosis codes for accuracy, completeness, specificity, and appropriateness based on the supporting medical documentation.
• Review medical records to identify appropriate diagnoses and coding opportunities according to applicable CMS HCC categories.
• Apply ICD-10-CM outpatient diagnosis coding guidelines accurately and consistently.
• Code diagnoses using an ICD-10-CM code book without relying on an encoder.
• Maintain comprehensive tracking and management tools for assigned medical record reviews.
• Meet established production and accuracy metrics consistently.
• Provide feedback and make coding corrections when discrepancies or inaccuracies are identified.
• Assist with training and education regarding appropriate coding of medical charts and supporting documentation when necessary.
• Maintain strict compliance with HIPAA requirements and protect the privacy, security, and confidentiality of medical records.
• Organize and manage coding-related documentation and tracking information accurately.

Successful candidates for this role are expected to possess the following attributes:

• Must have excellent English communication skills.
• Has the ability to complete projects in a timely manner and quickly adjust to changing circumstances and embrace new technologies, processes, or methods.
• Great logical and verbal reasoning skills.
• Exceptionally detail-oriented.
• Exceptional problem-solving and information-processing skills.
• Ability to think outside the box.
• A great work ethic and interest in learning new concepts and growing with the job.
• Ability to work both independently and as part of a team.
• Must have their own work device (preferably a desktop or laptop) and a stable internet connection.
• Must be comfortable with using a time-tracking software for payroll purposes.
• Must be willing to undergo a background verification check during the final stages of the hiring process.

Successful candidates for this role will be rewarded with the following benefits:

• A total of five paid vacation days per year (additional days can be taken unpaid).
• A 5% raise per year guaranteed (additional raises or bonuses may be given for outstanding performance).
• A paid 15-minute break for every 4 hours of work.
• Healthcare benefits after 2 months of full-time work.

* Vacation days increase by 1 vacation day per year. I.e. after one year of employment, the total paid vacation days on year 2 would be six, on year 3 seven, etc.

Our main focus is to build an energized and motivated workforce where our employees are happy and satisfied with their jobs and growth opportunities.

We are looking forward to making you a part of our team!

Thank you for your time and interest.