Clinical Documentation Coder: HCC & CMS Risk Adjustment

Bookmark Medical; United States; On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) with company match

Company funded HSA

Job summary

Bookmark Medical is seeking a skilled Risk Adjustment Coder to ensure accurate coding for CMS risk adjustment and HCC diagnoses. The role emphasizes high specificity, adherence to CMS guidelines, and protection of patient health information.

The candidate should have 3+ years of advanced coding experience, familiarity with EHRs (Athena, Epic, ECW), and knowledge of payer policies. This position supports a collaborative team focused on quality and compliance.

Qualifications

• 3+ years of advanced professional coding experience with HCC coding; CMS and HHS preferred.
• Familiarity with payer policies and guidelines.
• Familiarity with Electronic Health Records (Athena, Epic, ECW)

Responsibilities

• Review medical records on retrospective and prospective basis to identify, assess, monitor and document claims and encounter coding related to risk adjustment.
• Ensure diagnosis codes for chronic or major medical conditions are captured and submitted within the permitted timeframe.
• Assess documentation adequacy of claims and query outpatient provider claims to obtain additional medical record documentation or clarify documentation to ensure accurate coding.
• Audit provider documentation of ICD-10 codes and quality metrics to ensure CMS guideline adherence.
• Use coding principles to code to highest specificity and comply with CMS regulations and company goals and policies.
• Safeguard medical records and protect PHI per HIPAA and network policies on release, retention and security.

Skills

Advanced professional coding

HCC coding

Payer policies familiarity

Education

Professional Coding Certification (CPC/CCS/CCS-P)

Bachelor's degree preferred

Tools

Athena

Epic

ECW

Job description

Bookmark Medical is seeking a skilled Risk Adjustment Coder to ensure accurate coding for CMS risk adjustment and HCC diagnoses. The role emphasizes high specificity, adherence to CMS guidelines, and protection of patient health information.

The candidate should have 3+ years of advanced coding experience, familiarity with EHRs (Athena, Epic, ECW), and knowledge of payer policies. This position supports a collaborative team focused on quality and compliance.