Remote Risk Adjustment Coder – ICD-10 Expert

Florida Blue Group; Northern (KY); Hybrid; USD 39,000 - 62,000; Full time

Benefits offered by this job

Health insurance

Retirement plan with employer match

Paid time off

Job summary

Florida Blue Group is seeking a Risk Adjustment Coder to work remotely, collaborating with a dynamic team to ensure accurate diagnosis coding for risk adjustment. You will review records and apply ICD-10 codes in a compliant and timely manner.

Under the Sr. Manager Risk Adjustment Audit, you will meet production targets while upholding 95% quality in coding and participate in process improvements. A strong medical terminology background and remote-work capability are essential.

Qualifications

• 2+ years related work experience.
• High school diploma or GED.
• Active CPC/CCSP or AHIMA certification is required.
• Ability to work independently in a remote environment.
• Proficient with ICD-10-CM guidelines for coding and reporting.
• Experience in a production-based environment.
• Strong medical terminology knowledge.
• Proficient with Microsoft Office applications.

Responsibilities

• Review inpatient and/or outpatient records to assign diagnosis codes using ICD-10 to ensure accuracy and compliance in risk adjustment.
• Review and validate provider-submitted documentation and codes for accuracy.
• Meet production targets while maintaining 95% quality audit accuracy.
• Document coder observations not captured in standard records.
• Assist Provider Educator during audit results presentations.
• Update SOPs, DTPs, and related documents.
• Participate in coding tool enhancements and process improvements.

Skills

Independent work ethic

Detail oriented

Medical terminology knowledge

ICD-10-CM coding knowledge

Education

CPC/CCSP or AHIMA credential

Tools

Microsoft Office (Word, Excel, Outlook, PowerPoint)

Job description

Florida Blue Group is seeking a Risk Adjustment Coder to work remotely, collaborating with a dynamic team to ensure accurate diagnosis coding for risk adjustment. You will review records and apply ICD-10 codes in a compliant and timely manner.

Under the Sr. Manager Risk Adjustment Audit, you will meet production targets while upholding 95% quality in coding and participate in process improvements. A strong medical terminology background and remote-work capability are essential.