Remote HCC Risk Coder – Healthcare Data & Coding Impact

DaMar Staffing; United States; Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical Insurance for Employee and Sp.

Family coverage options at fraction of

401K retirement plan with 100% match

Paid holidays

Ample PTO for vacation/sick/personal

Job summary

Pathways Health Partners, Leesburg, FL, seeks a motivated HCC Risk Coder to support retrospective and concurrent chart reviews and assist with Health Plan audits. You will translate chronic conditions into ICD-10-CM codes and validate documentation per guidelines.

Responsibilities include data extraction, requesting medical records, and training staff on coding/compliance. A CRC or CPC is preferred, with 2+ years in a medical/health plan setting.

Qualifications

• High School Diploma or GED. An active CRC (certified risk adjustment coder) or CPC (certified professional coder) preferred.
• Understanding of regulations regarding medical coding and documentation; Administrative responsibilities, professional written and verbal communication, typing skills.
• Documented training in Medicare Risk Adjustment (MRA), HCC coding documentation guidelines, rules, and regulation.
• Two years' demonstrated experience in a medical or health plan environment
• Excellent computer skills with experience in Outlook, MS Office, MS Excel, MS Word

Responsibilities

• Review and assess documentation to accurately translate chronic conditions into the appropriate diagnosis codes from outpatient medical records.
• Extract data for Health Plan reports and input data collected from HCC programs.
• Assist in obtaining medical records from Providers to support audits requested by Health Plans.
• Help coordinate training sessions for Physicians and staff on relevant coding guidelines and compliance standards.
• Review provider documentation to verify that HCC codes are accurate and meet required documentation guidelines.
• Assign appropriate ICD-10-CM codes that map to risk adjustment models and identify documentation discrepancies, querying providers for clarity when necessary.
• Participate in clinical documentation improvement initiatives and maintain regular attendance at team meetings.
• Handle special projects as assigned and perform other duties as needed.

Skills

Medical coding knowledge

Strong computer skills

Education

High School Diploma or GED

CRC or CPC preferred

Tools

Outlook

MS Office

MS Excel

MS Word

Job description

Pathways Health Partners, Leesburg, FL, seeks a motivated HCC Risk Coder to support retrospective and concurrent chart reviews and assist with Health Plan audits. You will translate chronic conditions into ICD-10-CM codes and validate documentation per guidelines.

Responsibilities include data extraction, requesting medical records, and training staff on coding/compliance. A CRC or CPC is preferred, with 2+ years in a medical/health plan setting.