Remote Risk-Adjustment Medical Coder (HCC/CPC)

Insight Global; Tampa (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 Coding for a leading healthcare client. These professionals will review medical records to accurately assign ICD-10-CM codes that support risk adjustment and HCC reporting.

Ideal candidates will have strong experience with medical record review, coding compliance, CMS guidelines, and experience with Medicare Advantage. This role offers collaboration with providers and healthcare teams to improve documentation quality and

Qualifications

• Experience reviewing physician documentation and assigning ICD-10-CM codes.
• Strong understanding of risk adjustment and HCC coding.
• Familiarity with CMS guidelines and Medicare Advantage requirements.
• Experience with medical record reviews and coding compliance.

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 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 terminology

Clinical documentation review

Audit & QA

HIPAA compliance

Medicare Advantage

CMS-HCC models

Education

Certified coder (CPC/CCS/CRC/CCA)

Tools

EMR systems

Coding software

Job description

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

Ideal candidates will have strong experience with medical record review, coding compliance, CMS guidelines, and experience with Medicare Advantage. This role offers collaboration with providers and healthcare teams to improve documentation quality and