Risk-Adjustment Coding Specialist | Hybrid

SMG Brand; Knoxville (TN); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Summit Medical Group is seeking a Coding Support Specialist to conduct comprehensive documentation reviews of outpatient progress notes and assign ICD-10 codes to accurately reflect disease burden. This full-time, hybrid role requires expertise in risk adjustment and CMS RADV processes to ensure compliant coding and documentation.

Candidates should have an associates degree (bachelor's preferred) with coursework in ICD-9-CM/ICD-10-CM/CPT, anatomy, physiology, and medical terminology;

Qualifications

• Associates degree required; bachelor's preferred; coursework in ICD-9-CM, ICD-10-CM and CPT, anatomy & physiology, and medical terminology.
• Experience with CMS Medicare Advantage Risk Adjustment Data Validation and HCC coding is desirable.
• ICD-10 diagnosis coding experience in chart/progress note review.
• Ability to review clinical documentation and ensure accuracy of diagnosis codes for disease burden reporting.

Responsibilities

• Review progress notes for diagnosis coding accuracy to the highest level of specificity.
• Correct/assign ICD codes to meet documentation guidelines and policy.
• Identify trends for education and process improvements in clinical documentation.
• Communicate effectively to support risk mitigation and provider education.

Skills

ICD-10 coding

Clinical documentation

CMS RADV

Healthcare risk adjustment

Proficient computer skills

Education

Associates degree

Bachelor's preferred

ICD-9-CM / ICD-10-CM / CPT coursework

Tools

Electronic Health Records

CMS RADV tooling

Job description

Summit Medical Group is seeking a Coding Support Specialist to conduct comprehensive documentation reviews of outpatient progress notes and assign ICD-10 codes to accurately reflect disease burden. This full-time, hybrid role requires expertise in risk adjustment and CMS RADV processes to ensure compliant coding and documentation.

Candidates should have an associates degree (bachelor's preferred) with coursework in ICD-9-CM/ICD-10-CM/CPT, anatomy, physiology, and medical terminology;