Risk Adjustment HCC Coder: ICD-10 Expert (Onsite/Remote)

UST; Taguig; On-site; PHP 279,000 - 446,400; Full time

Job summary

UST in the Philippines is seeking a Risk Adjustment Coder to accurately review and assign ICD-10-CM codes for Medicare Advantage and ACA Risk Adjustment projects. The role requires strict adherence to coding guidelines, HIPAA, and documentation standards while supporting compliant risk adjustment reimbursement.

You will review records, map diagnoses to HCC models, identify CDI opportunities, and maintain high accuracy (≥97%) and productivity.

Qualifications

• 6+ months experience in Medical Coding, preferably HCC.
• Active coding certification from AAPC or AHIMA.
• CRC certification preferred.
• Proficient in ICD-10-CM coding.
• Strong clinical knowledge of chronic disease diagnosis, treatment and management.
• Experience in BPO environment is a plus.

Responsibilities

• Assign ICD-10-CM codes for Medicare Advantage and ACA Risk Adjustment projects.
• Review medical records and map diagnoses to Risk Adjustment/HCC models.
• Identify flag events and CDI opportunities for documentation discrepancies.
• Adhere to AHIMA Standards of Ethical Coding.
• Follow official ICD-10-CM guidelines and regulatory requirements.
• Ensure HIPAA compliance and data confidentiality.
• Maintain quality/accuracy targets (≥97%) and productivity.
• Stay updated with coding updates and reimbursement requirements.
• Participate in ongoing training and quality initiatives.

Skills

Medical Coding

HCC Risk Adjustment

ICD-10-CM

Attention to detail

Independent worker

Education

College degree

Tools

Microsoft Office

Coding software

Job description

UST in the Philippines is seeking a Risk Adjustment Coder to accurately review and assign ICD-10-CM codes for Medicare Advantage and ACA Risk Adjustment projects. The role requires strict adherence to coding guidelines, HIPAA, and documentation standards while supporting compliant risk adjustment reimbursement.

You will review records, map diagnoses to HCC models, identify CDI opportunities, and maintain high accuracy (≥97%) and productivity.