Remote HCC Risk Adjustment Coder (CRC)

TEKsystems; Jacksonville (FL); Remote; USD 44,083 - 50,971; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Paid time off

Job summary

TEKsystems is seeking a Senior Risk Adjustment/Coding Specialist to evaluate and ensure accuracy of risk adjustment reporting. The role involves reviewing both inpatient and outpatient records, ensuring CMS/HCC alignment, and protecting patient privacy under HIPAA.

This contract position is based out of Jacksonville, FL, but offers full remote work. Ideal candidates have 7+ years in risk adjustment coding, CRC certification, and strong MS Office skills.

Qualifications

• 7+ years of related professional experience.
• 5+ years of HCC coding experience in inpatient and outpatient coding guidelines.
• 5+ years of experience auditing Risk Adjustment records.
• 1+ years working in a Production environment.
• CRC (Certified Risk Coder) in good standing.
• Intermediate knowledge of Medicare, ACA, Commercial and Medicaid models.
• Critical thinking applied to coding policy interpretation and implementation.
• Experience providing written and verbal guidance on coding errors and trends.
• MS Office (Word, Excel, PowerPoint & Outlook).
• High school diploma or equivalent and work authorization in the U.S.

Responsibilities

• Evaluate risk adjustment codes to ensure accuracy and alignment with CMS/HCC guidelines.
• Protect patient records and audit information in HIPAA-compliant manner.
• Perform retrospective and prospective chart reviews to ensure accurate risk adjustment reporting.
• Verify and ensure accuracy of provider-reported diagnosis codes based on medical documentation.
• Review medical records to identify complete and accurate diagnosis code capture based on CMS HCCs.
• Maintain knowledge of relevant regulatory mandates and ensure compliance.
• Support audit and production efforts to meet business demand and deadlines.
• Provide written and verbal guidance on coding errors to others.
• Assist with special projects such as risk mitigation reviews.
• Serve as subject matter resource for risk adjustment and diagnosis coding.

Skills

Critical thinking

Written/verbal guidance

Production environment experience

Education

CRC (Certified Risk Coder)

High school diploma

Tools

MS Office

Job description

TEKsystems is seeking a Senior Risk Adjustment/Coding Specialist to evaluate and ensure accuracy of risk adjustment reporting. The role involves reviewing both inpatient and outpatient records, ensuring CMS/HCC alignment, and protecting patient privacy under HIPAA.

This contract position is based out of Jacksonville, FL, but offers full remote work. Ideal candidates have 7+ years in risk adjustment coding, CRC certification, and strong MS Office skills.