Risk Adjustment Coding Specialist (Remote in New York State)

CDPHP; City of Albany (NY); Remote; USD 45,000 - 75,000; Full time

Job summary

An established industry player in health insurance is seeking a detail-oriented coding specialist to join their team. This role involves conducting chart reviews, coding ICD-10 diagnoses, and ensuring compliance with HIPAA regulations. You'll have the opportunity to work in a flexible environment that supports remote work while contributing to a meaningful mission in the health insurance sector. The company offers a competitive salary, comprehensive benefits, and a supportive culture that values diversity and inclusion. If you're passionate about making a difference and have the required certifications, this could be the perfect opportunity for you.

Benefits

Competitive salary

Comprehensive benefits package

Flexible work environment

Generous paid time off

Incentive payments based on performance

Qualifications

• CCS/CCS-P or CPC/CPC-A certification required.
• Minimum one year of experience in a health care setting.

Responsibilities

• Conduct chart reviews and accurately code ICD-10 diagnoses.
• Collaborate with stakeholders to provide excellent customer service.

Skills

ICD-10 coding

medical terminology

customer service

attention to detail

Education

High school diploma or GED

Associate’s degree

Tools

Microsoft Office

Job description

Employer Industry: Health Insurance

Why consider this job opportunity:

1. Competitive salary with opportunities for professional and financial growth
2. Potential for incentive payments based on employee and company performance
3. Comprehensive benefits package, including award-winning health care coverage and generous paid time off
4. Flexible work environment that supports remote work
5. Chance to make a meaningful impact in the health insurance industry
6. Supportive corporate culture that values diversity, equity, and inclusion

What to Expect (Job Responsibilities):

1. Conduct chart reviews and accurately code ICD-10 diagnoses for risk adjustment eligible members
2. Retrieve medical records and participate in occasional diagnosis code projects
3. Apply knowledge of medical terminology, anatomy, and medical chart review to ensure accurate coding
4. Maintain compliance with HIPAA requirements and ensure confidentiality of patient health information
5. Collaborate with internal and external stakeholders to provide excellent customer service

What is Required (Qualifications):

1. High school diploma or GED required; Associate’s degree preferred
2. CCS/CCS-P (Certified Coding Specialist) or CPC/CPC-A (Certified Coding Professional) certification required
3. Minimum one (1) year of experience in an HMO, Managed Care Organization, or health care setting
4. Strong knowledge of ICD-10 diagnosis and procedure codes, CPT codes, Revenue codes, and HCPCS codes
5. Experience with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint

How to Stand Out (Preferred Qualifications):

1. CRC (Certified Risk Adjustment Coder) credential preferred
2. Knowledge of chronic conditions and experience in claims adjudication, billing, and enrollment systems
3. Experience with Clinical Documentation Improvement
4. Demonstrated ability to research and apply CMS and State coding guidelines
5. Proven track record of success working remotely without direct supervision