Risk Adjustment Coder: Precision ICD-10 & HCC Specialist

Our Clients; Taguig; On-site; PHP 420,000 - 640,000; Full time

Job summary

Our Clients is seeking a Risk Adjustment Coder to review records and assign precise ICD-10-CM codes in line with CMS-HCC guidance. You will ensure documentation supports accurate risk scores while maintaining quality and regulatory compliance.

You will work with EHR systems and coding software, stay updated on coding changes, and collaborate with CDI and QA teams to resolve complex coding questions.

Qualifications

• Bachelor's degree in Nursing or allied health preferred.
• Active coding certification (CPC, CRC, CCS, CIC) or equivalent preferred.
• 1–2 years of Risk Adjustment coding experience.
• Strong knowledge of ICD-10-CM, CMS-HCC, and HCC concepts.
• Experience with EHR and coding software.
• Analytical, critical thinking and problem-solving skills.
• Attention to detail with ability to meet quality and productivity goals.
• Good written and verbal communication skills.
• Ability to work independently and manage multiple priorities.

Responsibilities

• Review outpatient and physician records to assign accurate ICD-10-CM codes.
• Apply CMS-HCC guidelines and ensure proper HCC capture.
• Validate documentation to ensure diagnoses are supported and compliant.
• Maintain accuracy while meeting productivity and quality benchmarks.
• Stay current with ICD-10-CM, CMS-HCC, and regulatory updates.
• Participate in coding audits and implement corrective actions as needed.
• Collaborate with QA, CDI, providers, and operations to resolve questions.
• Maintain confidentiality and HIPAA compliance.
• Complete assigned coding tasks within turnaround times.
• Participate in training, calibration, and continuous improvement.

Skills

Analytical thinking

Critical thinking

Problem solving

Attention to detail

Verbal communication

Written communication

Independent work

Multitasking

Education

Bachelor's degree in Nursing or allied health

Active coding certification (CPC/CRC/CCS/CIC) or equivalent

Tools

EHR systems

Coding software

Job description

Our Clients is seeking a Risk Adjustment Coder to review records and assign precise ICD-10-CM codes in line with CMS-HCC guidance. You will ensure documentation supports accurate risk scores while maintaining quality and regulatory compliance.

You will work with EHR systems and coding software, stay updated on coding changes, and collaborate with CDI and QA teams to resolve complex coding questions.