Remote Risk-Adjustment Medical Coder (HCC)

Insight Global; Port Saint Lucie (FL); A distancia; USD 32.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Healthcare insurance

Paid leave

Descripción de la vacante

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.

Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence.

Formación

• 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 codes.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

Responsabilidades

• Review medical records and clinical data to identify reportable diagnoses.
• Assign accurate ICD-10-CM codes based on documentation.
• Identify diagnoses impacting Risk Adjustment and HCC reporting.
• Validate coded diagnoses against clinical evidence and standards.
• Perform prospective and retrospective chart reviews.
• Identify missed or mis-coded diagnoses.
• Ensure CMS, Medicare Advantage, HIPAA guidelines compliance.
• Participate in coding audits and quality initiatives.
• Communicate coding questions with providers and staff.
• Stay up to date on ICD-10, HCC, and CMS changes.

Conocimientos

Certified coder

ICD-10-CM

CMS guidelines

Risk Adjustment

HCC coding

Medical record review

Documentation accuracy

Herramientas

EMR systems

Coding software

Descripción del empleo

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.

Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence.