Risk Adjustment Coder - Remote (P)

Default GeBBS Healthcare Solutions; California; Remote; USD 70,000 - 110,000; Full time

Job summary

DaMar Staffing is seeking a qualified CMS HCC/Risk Validation coder for a flexible, seasonal audit project. The role allows nights and weekends and may lead to ongoing work beyond the season. You will review member and claim data, validate risk-adjusting diagnoses, and ensure coding accuracy.

Requirements include active AAPC or AHIMA certification, minimum 5 years post-cert risk adjustment coding experience, and a 95% accuracy target with a cap of 3 claims per hour. US-based candidates only.

Qualifications

• Active AAPC or AHIMA certification is required.
• Minimum 5 years verifiable risk adjustment coding experience post certification.
• Must maintain 95% accuracy and 3 CPH.

Responsibilities

• Review member and claim data validation aspects: name, DOB, gender, dates of service, claim type, provider signature.
• Review risk-adjusting diagnoses billed on a claim for a date of service or inpatient stay.
• Identify acceptable provider specialty.
• Demonstrate knowledge of ICD-10-CM IP and OP coding.
• Confirm or not confirm each diagnosis.
• Add risk-adjusting diagnoses that are valid but not reported.

Skills

ICD-10-CM coding

Risk adjustment

Attention to detail

Quality targets

Education

AAPC or AHIMA certification

Job description

Job Description

This is a flexible CMS HCC / Risk Validation Audit role for a seasonal project. Other opportunities for continued work may be available at the conclusion of the project. Flexible work hours - nights and weekends are acceptable.

Responsibilities

• Coders will review member and claim data validation aspects, which include :Member name, Member DOB, Gender, Dates of service, claim type, and provider signature
• Coders will be presented with all risk-adjusting diagnoses billed on a claim for a particular date of service or inpatient stay
• Must be able to identify acceptable provider specialty
• Coder must have knowledge of ICD-10-CM IP and OP coding
• Coders will confirm or not confirm each diagnosis
• Coders will add risk-adjusting diagnoses that are valid but not reported

Requirements

• Active certification through AAPC or AHIMA is required
• Minimum 5 years verifiable risk adjustment coding experience post certification
• Must be able to maintain a 95% accuracy rate and 3 CPH

US-Based Candidates Only.