Remote Risk Adjustment Medical Coder - HCC/CMS

Jobtome; Florida; Remote; USD 32,000 - 39,000; Full time

Benefits offered by this job

Healthcare insurance

Paid leave

Job summary

Jobtome is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. You will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes supporting risk adjustment and HCC reporting.

Ideal candidates have strong medical record review, coding compliance, and CMS guideline experience, ensuring diagnoses are supported by clinical evidence.

Qualifications

• Certified coder certifications required (CPC/CCS/CRC/CCA or equivalent).
• 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.
• Understanding of medical terminology, anatomy, physiology, and disease processes.
• Ability to interpret complex clinical documentation with high accuracy.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

Responsibilities

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

Skills

Certified coder (CPC, CCS, CRC, CCA,)

ICD-10-CM coding experience

Risk Adjustment knowledge

CMS guidelines familiarity

Medical record review background

Documentation interpretation

Physician documentation review

Anatomy & physiology knowledge

Job description

Jobtome is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. You will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes supporting risk adjustment and HCC reporting.

Ideal candidates have strong medical record review, coding compliance, and CMS guideline experience, ensuring diagnoses are supported by clinical evidence.