Risk Adjustment Coder: Precision in HCC & ICD-10 Coding

Create Synergies Inc.; Philippines; On-site; PHP 420,000 - 640,000; Full time

Job summary

Create Synergies Inc. is seeking a Risk Adjustment Coder to review medical records and assign ICD-10-CM codes in line with CMS-HCC guidelines. You will validate documentation, ensure accurate risk capture, and maintain high coding quality and productivity.

Responsibilities include staying current with ICD-10-CM and CMS-HCC updates, participating in audits, and collaborating with CDI, QA, providers, and operations to resolve coding questions. HIPAA compliance is essential.

Qualifications

• Bachelor's degree or higher in Nursing, Medical Technology, Pharmacy, Physical Therapy, Occupational Therapy, or allied health-related field preferred.
• Active coding certification such as CPC, CRC, CCS, CIC or equivalent preferred (CRC highly preferred for Risk Adjustment).
• Minimum of 1–2 years of Risk Adjustment coding experience.
• Strong knowledge of ICD-10-CM coding guidelines, CMS-HCC methodology, and HCC categories.
• Experience with EHR systems and coding software.

Responsibilities

• Review outpatient and physician records to assign accurate ICD-10-CM codes.
• Apply CMS-HCC Risk Adjustment guidelines and ensure proper HCC capture.

Skills

ICD-10-CM Coding

CMS-HCC Risk Adjustment

Medical terminology

Documentation requirements

EHR & coding software

Analytical thinking

Attention to detail

Time management

Education

Nursing degree

Medical Technology degree

Pharmacy degree

Physical Therapy degree

Occupational Therapy degree

Allied health degree

Tools

CRC Certification

Job description

Create Synergies Inc. is seeking a Risk Adjustment Coder to review medical records and assign ICD-10-CM codes in line with CMS-HCC guidelines. You will validate documentation, ensure accurate risk capture, and maintain high coding quality and productivity.

Responsibilities include staying current with ICD-10-CM and CMS-HCC updates, participating in audits, and collaborating with CDI, QA, providers, and operations to resolve coding questions. HIPAA compliance is essential.