Remote Risk Adjustment Coder (HCC/ICD-10 Expert)

Bluestone-Physician-Services; Stillwater (MN); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Health Insurance

Short and Long-term Disability

Health Savings Account (HSA) employer

Flexible Spending Account (FSA)

Retirement plan with 4% matching

10 paid holidays

Company sponsored laptop

Regular business hours

Job summary

Bluestone-Physician-Services is seeking a highly motivated Certified Risk Adjustment Coding Specialist to conduct thorough chart reviews and identify opportunities for accurate risk adjustment coding. The role emphasizes proper documentation to support disease capture and CMS requirements.

The position offers remote flexibility and requires working from Bluestone Markets (MN, WI, or FL). Salary ranges from $60,000 to $75,000 yearly, commensurate with experience and CMS guidelines.

Qualifications

• Proficiency in reviewing medical records for documentation deficiencies and coding opportunities.
• Strong understanding of ICD-10-CM coding guidelines related to risk adjustment.
• Excellent communication with Bluestoneproviders and clinical staff.
• Ability to educate and train Bluestoneprofessionals.
• Detail-oriented with analytical and problem-solving skills.
• Ability to work independently in remote/part-time roles.
• Knowledge of healthcare regulations and privacy laws.

Responsibilities

• Review medical records, provider documentation, and encounter notes to identify and validate reportable diagnoses.
• Assign accurate ICD-10-CM codes per guidelines and CMS requirements.
• Apply MEAT criteria to support diagnosis reporting.
• Identify documentation gaps; submit compliant provider queries when needed.
• Evaluate coding accuracy and clinical support in the record.
• Support prospective and retrospective risk adjustment reviews.
• Perform coding audits and contribute to quality improvement.
• Identify trends in coding discrepancies and propose improvements.
• Collaborate with providers, leadership, billing, coding, and quality teams.
• Stay current on CMS regulations and ICD-10-CM changes, including HCC model updates.
• Meet productivity, accuracy, and quality standards.
• Maintain HIPAA confidentiality.

Education

Bachelor’s degree preferred in Health Information Management, Nursing, Healthcare Administration, or related field

Job description

Bluestone-Physician-Services is seeking a highly motivated Certified Risk Adjustment Coding Specialist to conduct thorough chart reviews and identify opportunities for accurate risk adjustment coding. The role emphasizes proper documentation to support disease capture and CMS requirements.

The position offers remote flexibility and requires working from Bluestone Markets (MN, WI, or FL). Salary ranges from $60,000 to $75,000 yearly, commensurate with experience and CMS guidelines.