Remote Risk Adjustment Coder - ICD-10 Expert

Florida Blue; Jacksonville (FL); On-site; USD 39,000 - 62,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Benefits

Retirement Plan

Paid Time Off

Holiday & Wellness Days

Volunteer Time Off

Job summary

Florida Blue is seeking a Risk Adjustment Coder who can work remotely, reviewing medical records and applying ICD-10-CM codes to ensure risk adjustment accuracy while collaborating with a multidisciplinary team.

The role emphasizes meeting production targets with high quality audits and supporting education during audits, with opportunities to contribute to process improvements and documentation enhancements.

Qualifications

• 2+ years related work experience.
• Active CPC/CCSP or AHIMA certification.
• Ability to work independently in a remote environment.
• Proficient with ICD-10-CM Guidelines for coding and reporting.
• Previous production-based work experience.
• Strong understanding of medical terminology and anatomy.
• Intermediate MS Office proficiency.

Responsibilities

• Review inpatient/outpatient records to assign diagnosis codes using ICD-10 for risk adjustment.
• Validate provider-submitted codes and documentation for accuracy.
• Meet production targets with 95% quality audit accuracy.
• Document coder observations for non-production level insights.
• Assist Provider Educator during audit results presentation.
• Update SOPs, DTPs and related documents.
• Participate in process improvement initiatives.

Skills

ICD-10-CM guidelines

Certified coder CPC/CCSP/AHIMA

Remote work independence

Medical terminology

MS Office (Word, Excel, Outlook, Power

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Florida Blue is seeking a Risk Adjustment Coder who can work remotely, reviewing medical records and applying ICD-10-CM codes to ensure risk adjustment accuracy while collaborating with a multidisciplinary team.

The role emphasizes meeting production targets with high quality audits and supporting education during audits, with opportunities to contribute to process improvements and documentation enhancements.