Risk Adjustment Coder: HCC & Medical Coding Expert

Paycom - ATS; Cassin (TX); On-site; USD 65,000 - 95,000; Full time

Job summary

Gonzaba Medical Group is seeking a skilled Risk Adjustment Coder to document and validate acuity diagnoses for the Medicare Advantage population. You will review medical records, code ICD-10-CM, CPT, and HCPCS, and ensure documentation supports reported HCC codes under capitated contracts.

The role requires AHIMA or AAPC certification and 3+ years of Risk Adjustment experience, with HIPAA compliance and strong attention to detail.

Qualifications

• Active coding certification by AHIMA or AAPC required.
• 3+ years’ experience in Risk Adjustment (HCC) coding preferred.
• CPR with AED certification required.
• Minimum high school education or equivalent.

Responsibilities

• Maintain compliance with coding guidelines and policies.
• Provide guidance to clinicians on documentation to support accurate HCC coding.
• Select correct ICD-10-CM, CPT and HCPCS codes for HCC diagnosis codes.
• Review risk adjustment audits for accuracy and data entry into EMR.
• Identify and address documentation deficiencies with providers to meet timelines.
• Assist with queries to resolve incomplete or ambiguous documentation.

Skills

Risk Adjustment process

Medical coding knowledge

Provider queries

Documentation review

Education

AHIMA or AAPC coding certification (RHIA/RHIT/CCS/CCP or CPC/CRC)

Tools

EMR systems

ICD-10-CM CPT HCPCS coding

Job description

Gonzaba Medical Group is seeking a skilled Risk Adjustment Coder to document and validate acuity diagnoses for the Medicare Advantage population. You will review medical records, code ICD-10-CM, CPT, and HCPCS, and ensure documentation supports reported HCC codes under capitated contracts.

The role requires AHIMA or AAPC certification and 3+ years of Risk Adjustment experience, with HIPAA compliance and strong attention to detail.