Senior Risk Adjustment Coder — HCC & ICD-10 Expert

DaMar Staffing; Tampa (FL); On-site; USD 65,000 - 95,000; Full time

Job summary

Insight Global is seeking a Senior Medical Coder specializing in Risk Adjustment coding to review clinical data and assign ICD-10-CM codes that support risk adjustment and HCC reporting.

The role requires meticulous chart review, strong coding compliance, and familiarity with CMS and Medicare Advantage rules. Collaboration with providers will enhance documentation quality and coding accuracy.

Qualifications

• Must hold a professional coding certification (CPC/ CCS/ CRC/ CCA or equivalent).
• Strong experience with ICD-10-CM coding and medical record review.
• Knowledge of Risk Adjustment and HCC coding methodologies required.
• Experience reviewing physician documentation and assigning accurate diagnosis codes.
• Solid understanding of medical terminology, anatomy, physiology, and disease processes.

Responsibilities

• Review medical records and clinical data to identify reportable diagnoses.
• Assign ICD-10-CM codes based on documentation and coding guidelines.
• Identify diagnoses impacting Risk Adjustment and HCC reporting.
• Validate codes against clinical evidence and documentation standards.
• Perform prospective and retrospective chart reviews to improve accuracy.
• Identify missed or incorrectly coded diagnoses and communicate findings.
• Ensure CMS, Medicare Advantage, HIPAA, and internal coding requirements are met.
• Participate in coding audits and quality assurance initiatives.
• Collaborate with providers and clinical staff to clarify documentation.
• Keep up to date with ICD-10, HCC, and CMS regulatory changes.

Skills

Certified coder (CPC/ CCS/ CRC/ CCA)

ICD-10-CM coding

Risk Adjustment & HCC coding

Medical record review

Clinical terminology & anatomy

CMS guidelines

Documentation interpretation

Tools

EMRs

Coding software platforms

Job description

Insight Global is seeking a Senior Medical Coder specializing in Risk Adjustment coding to review clinical data and assign ICD-10-CM codes that support risk adjustment and HCC reporting.

The role requires meticulous chart review, strong coding compliance, and familiarity with CMS and Medicare Advantage rules. Collaboration with providers will enhance documentation quality and coding accuracy.