Risk Adjustment Coder

VillageCare; Remote; USD 77,000 - 88,000; Full time

Job summary

A health services organization is seeking a Remote Risk Adjustment Coder to perform critical coding tasks for medical records. Candidates should have a minimum of three years of experience in HCC/Risk Adjustment coding, possess relevant certifications such as CPC or CRC, and demonstrate excellent attention to detail. This role involves ensuring accurate coding, complying with CMS requirements, and contributing to quality initiatives. The position offers a competitive salary of $77,506.87 - $87,195.23 annually and requires residency in NY, NJ, or CT.

Qualifications

• At least three years of experience in HCC/Risk Adjustment and/or inpatient coding.
• Strong knowledge of claims processing procedures and systems.
• Excellent attention to detail and ability to maintain a productive home office.

Responsibilities

• Perform critical code abstraction of medical records and ensure accurate coding.
• Conduct comprehensive review of medical records for compliance with CMS requirements.
• Identify improvement opportunities in documentation and coding processes.

Skills

Attention to detail

Knowledge of clinical terminology

Experience in HCC/Risk Adjustment coding

Basic computer skills

Education

CPC, CRC, RHIT, or RHIA certification

Job description

Overview

Position: Risk Adjustment Coder
Location: Remote (Must reside in NY/NJ/CT)
Schedule: Monday - Friday 9am-5pm
Compensation: $77,506.87 - $87,195.23 annual salary

Responsibilities

• Perform critical code abstraction of medical records and ensure accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes supported by clinical documentation.
• Conduct comprehensive review of medical records to validate documentation meets CMS requirements, including provider signatures and relevant dates.
• Identify improvement opportunities in documentation and coding processes; participate in quality initiatives to enhance outcomes.
• Maintain current knowledge of coding standards and regulations; support Medicare Risk Adjustment team in educating providers on compliance and consistency.
• Report findings from audits, assist in analysis, and maintain a minimum coding quality audit accuracy of 95% while meeting productivity requirements.

Qualifications

• At least three years of experience in HCC/Risk Adjustment and/or inpatient coding.
• Certifications such as CPC, CRC, RHIT, or RHIA from AAPC or AHIMA.
• Strong knowledge of clinical terminology, disease processes, anatomy/physiology, and pharmacology.
• Strong knowledge of claims processing procedures and systems.
• State, Federal, and Medicare Regulations and Coordination of Benefits applications required.
• Must reside in NY, NJ, or CT.
• Excellent attention to detail, basic computer skills, and ability to maintain a productive home office with high-speed internet.
• Minimum five years of HCC/Risk Adjustment and/or inpatient coding experience.
• Certification through AAPC or AHIMA (CPC, CRC, RHIT, or RHIA).

VillageCare is an Equal Opportunity Employer.

Salary: $77,506.87 - $87,195.23 per year

Job Posted by ApplicantPro