Remote Risk Adjustment Coder — ICD-10 & HCC Expert

Jobtome; Fort Lauderdale (FL); Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

Healthcare insurance

Paid leave

Job summary

Insight Global is seeking Medical Coders specializing in Risk Adjustment for a leading healthcare client in Fort Lauderdale, FL. You will review medical records and assign ICD-10-CM codes to support risk adjustment and HCC reporting.

Ideal candidates have strong medical record review experience, knowledge of CMS guidelines, and the ability to ensure diagnoses are fully supported by clinical evidence. Prior Medicare Advantage and HCC coding experience is highly valued.

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 HCC coding methodologies.
• Experience reviewing physician documentation and assigning accurate diagnosis codes.
• Strong understanding of medical terminology, anatomy, physiology and disease processes.
• Ability to interpret complex clinical documentation with high accuracy and productivity.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

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

CMS guidelines

Medical record review

Anatomy and physiology

Job description

Insight Global is seeking Medical Coders specializing in Risk Adjustment for a leading healthcare client in Fort Lauderdale, FL. You will review medical records and assign ICD-10-CM codes to support risk adjustment and HCC reporting.

Ideal candidates have strong medical record review experience, knowledge of CMS guidelines, and the ability to ensure diagnoses are fully supported by clinical evidence. Prior Medicare Advantage and HCC coding experience is highly valued.