Risk-Adjustment Medical Coder (HCC/ICD-10)

Insight Global; United States; Remote; USD 32,000 - 39,000; Full time

Job summary

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.

Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence.

Qualifications

• Certified coder with CPC/CCS/CRC/CCA or equivalent credential.
• Proven ICD-10-CM coding experience and medical record review.
• Knowledge of Risk Adjustment and HCC coding methodologies.
• Experience reviewing physician documentation and assigning diagnoses.
• Strong medical terminology, anatomy, physiology, and disease knowledge.
• Ability to interpret complex clinical documentation accurately.
• Familiarity with CMS guidelines and Medicare Advantage requirements.

Responsibilities

• Review medical records and clinical data to identify reportable diagnoses.
• Assign accurate ICD-10-CM codes based on guidelines and documentation.
• Identify diagnoses impacting Risk Adjustment and HCC reporting.
• Validate coded diagnoses against clinical evidence and standards.
• Perform prospective and retrospective chart reviews.
• Identify missed or incorrectly coded diagnoses.
• Ensure CMS, Medicare Advantage, HIPAA, and organizational coding compliance.
• Participate in coding audits and quality assurance initiatives.
• Communicate coding questions with providers and clinical staff.
• Stay up to date on ICD-10, HCC, and CMS regulatory changes.

Skills

Certified coder certification

ICD-10-CM coding experience

Risk Adjustment knowledge

Physician documentation review

Medical terminology knowledge

Clinical documentation interpretation

CMS guidelines familiarity

Tools

EMRs

Coding software platforms

Job description

Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.

Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence.