Remote Risk-Adjustment Medical Coder (HCC/ICD-10)

Jobrapido; Lawrenceville (GA); 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 to review medical records and assign ICD-10-CM codes supporting risk adjustment and HCC reporting.

Ideal candidates will have strong medical record review experience, coding compliance, CMS guidelines knowledge, and the ability to ensure diagnoses are fully supported by clinical evidence. Medicare Advantage and HCC coding experience is highly valued.

Qualifications

• Certified coder with ICD-10-CM and medical record review experience.
• Solid understanding of risk adjustment and HCC coding methodologies.
• Ability to review physician documentation and assign accurate codes.
• Strong knowledge of CMS guidelines and Medicare Advantage requirements.
• High accuracy in interpreting complex clinical documentation.

Responsibilities

• Review medical records and physician documentation to identify reportable diagnoses.
• Assign ICD-10-CM codes based on guidelines and documentation.
• Identify diagnoses impacting Risk Adjustment and HCC reporting.
• Validate codes against clinical evidence and standards.
• Conduct prospective and retrospective chart reviews.
• Participate in coding audits and quality assurance initiatives.
• Communicate coding questions with providers and clinical staff.
• Stay updated on ICD-10, HCC, and CMS regulatory changes.

Skills

ICD-10-CM experience

Medical record review

CMS guidelines knowledge

Clinical documentation interpretation

Medical terminology knowledge

CMS Medicare Advantage familiarity

Education

Certified coder certification (CPC/CCS/CRC/CCA)

CRC certification

Tools

EMRs and coding software platforms

Job description

Insight Global is seeking Medical Coders specializing in Risk Adjustment to review medical records and assign ICD-10-CM codes supporting risk adjustment and HCC reporting.

Ideal candidates will have strong medical record review experience, coding compliance, CMS guidelines knowledge, and the ability to ensure diagnoses are fully supported by clinical evidence. Medicare Advantage and HCC coding experience is highly valued.