Medical Coder

HireTalent; United States; In loco; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

HireTalent seeks an experienced Risk Adjustment Medical Coder to support ACA risk adjustment initiatives within a client health plan environment. The role emphasizes HCC and ICD-10 coding, with blind coding and internal guideline adherence as core duties.

The candidate should have CPC certification, 3+ years of risk adjustment coding experience, and familiarity with Epic EMR or Veradigm platforms. This position focuses on ACA/commercial risk adjustment and supports a critical coding season.

Competenze

• CPC certification is strongly preferred; CRC considered.
• Minimum 3 years of risk adjustment coding experience.
• Experience assigning HCC and ICD-10 diagnosis codes.
• Ability to independently review medical records and perform blind coding.
• Experience in risk adjustment programs for health plans, providers, or vendors.

Mansioni

• Review EMRs and PDFs for risk adjustment coding opportunities.
• Perform blind coding and identify HCCs and ICD-10 codes from clinical documentation.
• Validate and assign accurate risk-adjusted diagnoses per ACA/CMS guidelines.
• Analyze records to identify reportable conditions and coding opportunities.
• Maintain productivity of 40-70 charts per day depending on complexity.
• Adhere to internal SOPs, quality standards, and compliance requirements.
• Collaborate with coding leadership, auditors, and team via Slack and other channels.

Conoscenze

CPC certification

Risk adjustment coding

HCC coding

ICD-10 coding

Independent chart review

Formazione

Associate's or Bachelor’s degree

Strumenti

Epic EMR

Veradigm risk adjustment platforms

Descrizione del lavoro

We are seeking an experienced Risk Adjustment Medical Coder to support our client's Commercial/ACA Risk Adjustment team during a critical coding season. This individual will review medical records, identify and assign risk-adjusted diagnoses, and perform blind coding using internal coding guidelines.

This role focuses exclusively on Affordable Care Act (ACA)/Commercial Risk Adjustment and is ideal for candidates with strong HCC and ICD-10 coding experience in a health plan, provider, or vendor environment. Medicare-only risk adjustment experience is not sufficient for this position.

Key Responsibilities

• Review electronic medical records (EMRs) and PDF medical records for risk adjustment coding opportunities.
• Perform blind coding and independently identify HCCs and ICD-10 diagnosis codes from clinical documentation.
• Validate and assign accurate risk-adjusted diagnoses according to ACA, CMS, and organizational coding guidelines.
• Analyze medical records to identify reportable conditions and coding opportunities.
• Maintain productivity expectations ranging from 40-70 charts per day depending on record complexity and project type.
• Adhere to internal coding SOPs, quality standards, and compliance requirements.
• Collaborate with coding leadership, auditors, and team members through Slack and other internal communication channels.

Must-Have Skills

• CPC (Certified Professional Coder) certification strongly preferred. CRC certifications will be considered; however, CPC is the preferred credential.
• Minimum 3 years of Risk Adjustment Coding experience.
• Experience assigning HCC and ICD-10 diagnosis codes.
• Ability to independently review medical records and perform blind coding.
• Experience working within risk adjustment programs for health plans, provider groups, or healthcare vendors.

Preferred Qualifications

• Experience using Epic EMR
• Experience with Veradigm risk adjustment platforms.
• Combined ACA and Medicare Risk Adjustment experience.
• Associate's or Bachelor's degree in a related field.
• Experience working in high-volume chart review environments.

Preferred Technical Experience

• EMR Systems: Epic (preferred), other EMR systems accepted.
• Documentation Review: EMR and PDF chart review..

What the Client Provides

• Company-issued laptop and equipment.
• Epic access and EMR credentials.
• Internal coding guidelines and SOPs.
• Structured onboarding and training resources.