Risk Adjustment Coding Specialist - Remote

Trinity Health; Columbus (OH); Remote; USD 55,000 - 75,000; Full time

Job summary

Trinity Health is seeking a Risk Adjustment Coding Specialist to ensure accurate coding of medical diagnoses. This full-time remote position requires responsibility for compliance with risk adjustment methods and collaboration with healthcare teams to enhance coding quality while ensuring proper documentation practices.

Benefits

Medical, dental, and vision coverage starting on day one

Retirement savings account with employer match

Generous paid time off programs

Employee recognition programs

Tuition/professional development reimbursement

Relocation assistance

Discounted tuition at affiliated college

Employee Referral Rewards program

DailyPay option

Diversity, Equity, and Inclusion Resource Groups

Qualifications

• CPC certification required within one year.
• Minimum of two years of experience in medical coding and billing.

Responsibilities

• Reviews patient records to identify Gaps in Care.
• Communicates documentation improvements to providers.
• Collaborates on clinical documentation modifications.

Skills

Medical coding

ICD-9/10 documentation

Compliance

Gaps in Care communication

Education

High school graduate or GED

Job description

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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

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.

00596468

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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