Senior Risk Adjustment Coder - HCC & ICD-10 Expert

Cano Health LLC; United States; On-site; USD 85,000 - 110,000; Full time

Job summary

Cano Health LLC is seeking a Risk Adjustment Coder III to ensure accurate ICD-10-CM coding and timely chart reviews in support of risk adjustment models. The role emphasizes adherence to guidelines, audit readiness, and collaboration with clinical teams.

Candidates should have CPC/CCS certifications and at least 5 years of medical coding experience with risk adjustment, working within established policies to maintain data integrity and regulatory compliance.

Qualifications

• 5 years of medical coding experience with focus on risk adjustment or HCC.
• Excellent knowledge of ICD-10-CM coding conventions and guidelines.
• Strong analytical skills with attention to detail.
• Ability to review and interpret medical records and clinical documentation.

Responsibilities

• Assign ICD-10-CM diagnosis codes based on medical records following guidelines.
• Perform detailed chart reviews to ensure accurate capture of diagnoses including HCC codes.
• Identify and correct coding discrepancies based on documented evidence.
• Apply CMS-HCC and other risk adjustment guidelines in daily work activities.
• Participate in routine coding audits and apply feedback to improve accuracy.
• Collaborate with coding team, clinical documentation staff, and leadership to resolve issues.
• Maintain knowledge of ICD-10-CM updates and risk adjustment guidelines.

Skills

Analytical skills

Attention to detail

Communication skills

Independent work

Auditing experience

Education

Associate degree or certification in Health Information Management

Certified Professional Coder (CPC)

Certified Coding Specialist (CCS)

Certified Risk Adjustment Coder (CRC) preferred

5 years medical coding experience with risk adjustment

Job description

Cano Health LLC is seeking a Risk Adjustment Coder III to ensure accurate ICD-10-CM coding and timely chart reviews in support of risk adjustment models. The role emphasizes adherence to guidelines, audit readiness, and collaboration with clinical teams.

Candidates should have CPC/CCS certifications and at least 5 years of medical coding experience with risk adjustment, working within established policies to maintain data integrity and regulatory compliance.