Remote Risk Adjustment Coder – HCC & CMS Expert

Jobrapido; El Paso (TX); Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

Healthcare insurance offerings

Paid leave

Job summary

Jobrapido seeks Medical Coders specializing in Risk Adjustment for a leading healthcare client in the United States. You will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.

Ideal candidates have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence.

Qualifications

• Certified coder with CPC/CCS/CRC/CCA or equivalent certification.
• Strong ICD-10-CM coding experience and medical record review background.
• Knowledge of Risk Adjustment and CMS-HCC methodologies.
• Ability to interpret complex clinical documentation with high accuracy.

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

Certified coder

ICD-10-CM coding

Risk adjustment

HCC coding

Medical record review

CMS guidelines

Medicare Advantage

Tools

EMR systems

coding software

Job description

Jobrapido seeks Medical Coders specializing in Risk Adjustment for a leading healthcare client in the United States. You will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.

Ideal candidates have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence.