Remote HCC Risk Adjustment Auditor (Physician Coder)

Pinnacle Healthcare Consulting; United States; Remote; USD 55,000 - 83,000; Part time

Job summary

Pinnacle Enterprise Risk Consulting Services is seeking a REMOTE HCC Risk Adjustment and Professional-Fee (Physician) Reviewer / Auditor / Coder for as-needed, part-time hours on a 1099 basis. The role requires active coder certification and experience in Medicare risk adjustments, with a focus on accuracy and compliance.

The candidate will review records, abstract codes, and ensure payer guidelines are followed, while maintaining productivity in a remote setup.

Qualifications

• Active professional coding certification (CRC, CPC, CPMA or CCS) and current good standing with AHIMA or AAPC.
• Minimum four years as a certified coder/auditor in multi-specialty settings.
• Minimum two years in risk adjustment and provider evaluation and management (E/M).
• Ability to code ICD-10, modifiers, CPT/HCPCS.
• Strong computer proficiency including MS Office, Internet, and data portals.

Responsibilities

• Review medical records via PDF or EMR and assign CPT/HCPCS, ICD, and modifiers.
• Abstract and assign codes accurately.
• Research and resolve coding projects and document findings.
• Ensure legible documentation and valid signatures.
• Identify valid face-to-face encounters and analyze chart data for compliance.
• Meet daily production and quality goals (≈95% accuracy).
• Attend conference calls as needed.

Skills

Anatomy terminology

Medicare guidelines

Remote work discipline

Multi-tasking

Attention to detail

Communication skills

Analytical skills

Education

AHIMA/AAPC certification (CRC/CPC/CPMA/CCS)

High School diploma

College degree preferred

Tools

MS Windows

MS Office (Excel/Word)

Microsoft Access

Internet

Job description

Pinnacle Enterprise Risk Consulting Services is seeking a REMOTE HCC Risk Adjustment and Professional-Fee (Physician) Reviewer / Auditor / Coder for as-needed, part-time hours on a 1099 basis. The role requires active coder certification and experience in Medicare risk adjustments, with a focus on accuracy and compliance.

The candidate will review records, abstract codes, and ensure payer guidelines are followed, while maintaining productivity in a remote setup.