Risk Adjustment Medical Coder — HCC & CMS Expert

Insight Global; Tampa (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. The role involves reviewing medical records and clinical documentation to assign ICD-10-CM codes that support risk adjustment and HCC reporting.

Candidates with Medicare Advantage and HCC experience are highly sought after. You will work with providers and healthcare teams to improve coding accuracy, enhance documentation quality, and support critical risk adjustment initiatives.

Qualifications

• Certified coder with CPC/ CCS/ CRC/ CCA or equivalent.
• Strong ICD-10-CM coding experience and medical record review.
• Knowledge of Risk Adjustment and HCC coding methodologies.
• Experience reviewing physician documentation and assigning accurate codes.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

Responsibilities

• Review medical records, physician documentation, and clinical data to identify reportable diagnoses.
• Assign ICD-10-CM diagnosis codes based on coding guidelines and documentation.
• Identify diagnoses impacting Risk Adjustment and HCC reporting.
• Validate coded diagnoses against clinical evidence and documentation standards.
• Participate in coding audits and quality assurance initiatives.
• Communicate coding and documentation questions with providers and clinical staff.

Skills

ICD-10-CM coding

Medical record review

CMS guidelines

HCC coding

Documentation accuracy

Job description

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. The role involves reviewing medical records and clinical documentation to assign ICD-10-CM codes that support risk adjustment and HCC reporting.

Candidates with Medicare Advantage and HCC experience are highly sought after. You will work with providers and healthcare teams to improve coding accuracy, enhance documentation quality, and support critical risk adjustment initiatives.