Remote HCC/Risk Adjustment Coder

Jobrapido; Bismarck (ND); 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 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.

Qualifications

• Certified coder certifications (CPC/CCS/CRC/CCA or equivalent) required.
• Extensive ICD-10-CM coding experience with medical record review.
• Knowledge of risk adjustment and HCC coding methodologies.
• Experience reviewing physician documentation and assigning diagnosis codes.
• Strong medical terminology, anatomy, physiology, and disease knowledge.
• Ability to interpret complex clinical documentation with high accuracy and productivity.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

Responsibilities

• Review medical records and clinician notes to identify reportable diagnoses.
• Assign accurate ICD-10-CM codes based on 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

Certified coder credentials

ICD-10-CM coding

Risk Adjustment & HCC

Physician documentation reviews

Medical terminology knowledge

Clinical documentation interpretation

CMS guidelines familiarity

Tools

EMRs and coding software

CMS-HCC models

Job description

Insight 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.