Remote Risk Adjustment Coder | Medicare Advantage HCC

Jobrapido; Kansas City (MO); Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

Healthcare insurance

Paid leave

Job summary

Jobrapido is seeking a Medical Coder specialized in Risk Adjustment for a leading healthcare client in the United States. The role emphasizes reviewing medical records to accurately assign ICD-10-CM codes that support risk adjustment and CMS reporting.

Ideal candidates will demonstrate strong coding accuracy, CMS guideline knowledge, and experience with risk adjustment processes, HCC reporting, and audits to ensure compliance and data quality.

Qualifications

• Certified coder with CPC/CCS/CRC/CCA or equivalent certification.
• Experience with ICD-10-CM coding and medical record review.
• Knowledge of Risk Adjustment and HCC coding methodologies and CMS guidelines.

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

Medical record review

Risk Adjustment

HCC coding

CMS guidelines

Tools

EMR systems

coding software platforms

CMS-HCC models

Job description

Jobrapido is seeking a Medical Coder specialized in Risk Adjustment for a leading healthcare client in the United States. The role emphasizes reviewing medical records to accurately assign ICD-10-CM codes that support risk adjustment and CMS reporting.

Ideal candidates will demonstrate strong coding accuracy, CMS guideline knowledge, and experience with risk adjustment processes, HCC reporting, and audits to ensure compliance and data quality.