Risk Adjustment Coder

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

Benefits offered by this job

Five paid vacation days per year

5% annual raise

Paid 15-minute break every 4 hours

Healthcare benefits after 2 months

Vacation days increase yearly

Job summary

AbroadWorks, Inc. is seeking a certified Risk Adjustment Coder for a fully remote role based in the Philippines. You will review medical records, capture and validate diagnosis codes, and apply CMS HCC categories while working independently in a remote environment.

The ideal candidate has at least two years of risk adjustment coding experience, strong clinical knowledge of chronic illnesses, and a detail-oriented, analytical mindset to meet production and quality targets.

Qualifications

• Active professional coding certification (AHIMA or AAPC) such as CRC, CPC, or CCS-P.
• Minimum of 2 years as a certified risk adjustment coder in managed care.
• Strong knowledge of HCC coding models and CMS HCC categories.
• Ability to code using ICD-10-CM without an encoder.
• HIPAA compliance and data privacy knowledge.

Responsibilities

• Review medical records to ensure diagnosis codes are accurate and documented.
• Assess codes for accuracy, completeness, specificity, and appropriateness.
• Apply CMS HCC categories and ICD-10-CM guidelines consistently.
• Code diagnoses using ICD-10-CM and review for opportunities.
• Maintain tracking tools for medical record reviews and meet production targets.

Skills

Analytical skills

Attention to detail

Independent worker

English communication

Education

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

Tools

ICD-10-CM coding 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.