REMOTE Ambulatory Services Medical Coder

Insight Global; Tallahassee (FL); Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

Healthcare insurance

Paid leave

Job summary

Insight Global is seeking Medical Coders specializing in Risk Adjustment to review medical records and assign ICD-10-CM codes that support risk adjustment and HCC reporting. Candidates should have strong medical record review experience and CMS guidelines familiarity to ensure evidence-based coding.

Ideal applicants will work with providers and clinical teams to improve coding accuracy and documentation quality, with emphasis on HCC reporting and regulatory compliance.

Qualifications

• Certified coder with CPC/CCS/CRC/CCA or equivalent
• Strong ICD-10-CM coding experience and medical record review background
• Knowledge of Risk Adjustment and HCC methodologies
• Experience reviewing physician documentation and assigning accurate diagnosis codes
• Strong understanding of medical terminology, anatomy, physiology, and disease processes
• Ability to interpret complex clinical documentation with high accuracy and productivity
• Familiarity with CMS guidelines and Medicare Advantage requirements

Responsibilities

• Review medical records, physician documentation, and clinical data to identify reportable diagnoses
• Assign accurate ICD-10-CM diagnosis codes based on coding guidelines and documentation
• Identify diagnoses impacting Risk Adjustment and HCC reporting
• Validate coded diagnoses against clinical evidence and documentation standards
• Perform prospective and retrospective chart reviews
• Identify missed, unsupported, or incorrectly coded diagnoses
• Ensure compliance with CMS, Medicare Advantage, HIPAA, and organizational coding requirements
• Participate in coding audits and quality assurance initiatives
• Communicate coding and documentation questions with providers and clinical staff
• Stay up to date on ICD-10, HCC, and CMS regulatory changes

Skills

CPC/CCS/CRC/CCA

ICD-10-CM coding

Risk Adjustment

CMS guidelines

clinical documentation review

medical terminology

accuracy & productivity

Tools

EMRs

Coding software platforms

Job description

Required Skills & Experience

• Certified coder (CPC, CCS, CRC, CCA, or equivalent certification)
• Strong ICD-10-CM coding experience and medical record review background
• Knowledge of Risk Adjustment and HCC coding methodologies
• Experience reviewing physician documentation and assigning accurate diagnosis codes
• Strong understanding of medical terminology, anatomy, physiology, and disease processes
• Ability to interpret complex clinical documentation with high accuracy and productivity
• Familiarity with CMS guidelines and Medicare Advantage requirements

Nice to Have Skills & Experience

• Medicare Advantage Risk Adjustment experience
• Experience working with CMS-HCC models
• CRC (Certified Risk Adjustment Coder) certification
• Experience with EMRs and coding software platforms
• Background in a health plan, physician practice, hospital, or revenue cycle environment
• Audit and quality assurance experience

Job DescriptionInsight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence. This role offers the opportunity to work closely with providers and healthcare teams to improve coding accuracy, enhance documentation quality, and support critical risk adjustment initiatives. Candidates with Medicare Advantage and HCC coding experience will be highly sought after.

Day-to-Day

• Review medical records, physician documentation, and clinical data to identify reportable diagnoses
• Assign accurate ICD-10-CM diagnosis codes based on coding guidelines and documentation
• Identify diagnoses impacting Risk Adjustment and HCC reporting
• Validate coded diagnoses against clinical evidence and documentation standards
• Perform prospective and retrospective chart reviews
• Identify missed, unsupported, or incorrectly coded diagnoses
• Ensure compliance with CMS, Medicare Advantage, HIPAA, and organizational coding requirements
• Participate in coding audits and quality assurance initiatives
• Communicate coding and documentation questions with providers and clinical staff
• Stay up to date on ICD-10, HCC, and CMS regulatory changes

Compensation: $23- $28 per hour.Exact compensation may vary based on several factors, including skills, experience, and education.

Benefits

• Benefit packages for this role may include healthcare insurance offerings and paid leave as provided by applicable law.