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Risk Adjustment Coding Specialist

Trinity Health

Columbus (OH)

Remote

USD 55,000 - 70,000

Full time

9 days ago

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Job summary

A leading healthcare organization seeks a Risk Adjustment Coding Specialist for a remote position. The role focuses on coding medical diagnoses using HCC methodologies, ensuring compliance and accuracy for reimbursement processes. Ideal candidates will have a CPC certification and two years of relevant experience, along with a collaborative spirit to work with healthcare providers on documentation improvements. This position offers competitive compensation, benefits from day one, and opportunities for professional development.

Benefits

Competitive compensation and benefits

Retirement savings account with employer match

Generous paid time off

Employee recognition programs

Tuition reimbursement

Relocation assistance

Qualifications

CPC certification required.
Minimum of two years of experience in medical coding and billing.
Certified Risk Adjustment Coder certification to be obtained within one year of hire.

Responsibilities

Reviews patient records for Gaps in Care and communicates these to providers.
Collaborates with providers to improve clinical documentation.
Ensures compliance with industry standards and guidelines.

Skills

ICD-9/10 Documentation

Compliance

Risk Adjustment Coding

Education

High school graduate or GED

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Description:

The HCC Risk Coder is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.

Employment Type

Full time

Shift

Description:

The HCC Risk Coder is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.

Position Purpose

Risk Adjustment Coding Specialist works in a team environment and is responsible for ensuring accurate ICD-9/10 documentation and capturing the HCC diagnostics code for the patient billing process.The HCC Risk Coder is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.
Specialty: Medical Group
Location: Remote
Hours of office: Monday – Friday: 5:30a – 4:30p or 6:00p

What You Will Do

Reviews patient record prior to appointment to determine Gaps in Care, then communicates Gaps to provider.
Recognizes opportunities for documentation improvement and educates providers and staff of suggested improvements.
Collaborates with providers to formulate appropriate modifications to clinical documentation to reflect the appropriate use of clinical codes and documentation

Minimum Qualifications

Education: High school graduate or GED required
Licensure / Certification:

CPC required
Certified Risk Adjustment Coder certification within one year of hire required.

Experience: Minimum of two years of experience in medical coding and billing required

Position Highlights And Benefits

Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
Retirement savings account with employer match starting on day one.
Generous paid time off programs.
Employee recognition programs.
Tuition/professional development reimbursement.
Relocation assistance (geographic and position restrictions apply).
Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.
Employee Referral Rewards program.
Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!
Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

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Seniority level

Seniority level
Entry level

Employment type

Employment type
Full-time

Job function

Job function
Health Care Provider
Industries
Hospitals and Health Care

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