Remote Risk Adjustment Medical Coder (HCC/Coding)

Jobrapido; Boise (ID); 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 Coding for a leading healthcare client in Boise, Idaho. You will review medical records and clinical documentation to accurately assign ICD-10-CM codes that support risk adjustment and HCC reporting.

Ideal candidates will have strong medical record review, coding compliance, and CMS guideline knowledge, ensuring diagnoses are fully supported by evidence. Experience with Medicare Advantage and HCC coding is highly valued.

Qualifications

• Certified coder with CPC/CCS/CRC/CCA or equivalent.
• Strong ICD-10-CM coding experience and medical record review background.
• Knowledge of Risk Adjustment and HCC methodologies.
• Experience reviewing physician documentation and assigning accurate diagnosis codes.
• Strong clinical terminology, anatomy, physiology and disease knowledge.
• Ability to interpret complex clinical documentation with high accuracy.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

Responsibilities

• Review medical records and physician documentation to identify reportable diagnoses.
• Assign accurate ICD-10-CM codes based on documentation and guidelines.
• Identify diagnoses impacting Risk Adjustment and HCC reporting.
• Validate coded diagnoses against clinical evidence and standards.
• Participate in prospective and retrospective chart reviews.
• Ensure compliance with CMS, Medicare Advantage, HIPAA and coding requirements.
• Contribute to coding audits and quality assurance initiatives.
• Communicate coding questions with providers and clinical 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 & HCC knowledge

Physician documentation review

Medical terminology & anatomy

Interpret complex clinical docs

CMS guidelines & Medicare Advantage

Tools

EMRs

Coding software platforms

Job description

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

Ideal candidates will have strong medical record review, coding compliance, and CMS guideline knowledge, ensuring diagnoses are fully supported by evidence. Experience with Medicare Advantage and HCC coding is highly valued.