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

Jobrapido; Roanoke (VA); 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

• Must hold a certified coder credential (CPC/CCS/CRC/CCA or equivalent).
• Experience with ICD-10-CM coding and medical record review.
• Knowledge of CMS guidelines and Medicare Advantage requirements.

Responsabilidades

• 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 compliance with 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.

Conocimientos

Certified coder

ICD-10-CM coding experience

Risk Adjustment & HCC knowledge

Reviewing physician documentation

Medical terminology & anatomy

Clinical documentation interpretation

CMS guidelines & Medicare Advantage

Herramientas

EMRs

Coding software platforms

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.