Coder 1 – HCC Risk Adjustment

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate medical records to ensure diagnosis code abstraction is accurate, compliant, and complete across various chart and encounter types.

• Assist with Medicare, Commercial, and Medicaid risk-adjustment program initiatives, including prospective, concurrent, and retrospective evaluations.

• Keep up-to-date on coding standards through required Cotiviti training sessions, workshops, and individual research.

• Report findings, errors, and recommendations to the Team Lead.

• Utilize established dispute-resolution processes when discrepancies in coding occur.

• Fulfill responsibilities related to performance reviews and goal setting.

• Undertake special projects and other assigned tasks as necessary.

• Execute duties with or without reasonable accommodation.

⛳️ Requirements

• A minimum of a High School Diploma is required.

• Must hold a nationally recognized coding certification in good standing from AAPC or AHIMA (e.g., CRC, CPC, CCS).

• 1-2 years of experience in medical risk adjustment or HCC coding is preferred.

• Familiarity with HCC record abstraction and coding requirements is essential.

• Proven track record of high-quality accuracy and productivity in clinical coding tasks.

• Maintain professional credentials in good standing as mandated by AAPC and/or AHIMA.

• Adherence to official coding guidelines, coding clinic determinations, CMS, client-specific guidelines, and other regulatory compliance standards is required.

• Strong understanding of medical terminology, anatomy, and physiology.

• Intermediate computer skills with the ability to effectively use designated coding platforms, emphasizing both productivity and accuracy.

• Proficient organizational and time management skills.

• Ability to read and interpret medical record documentation for diagnosis extraction.

• Comfortable using computers and technology.

• Must comply with all HIPAA regulations and maintain patient confidentiality.

• Availability for required training Monday-Friday from 8 AM to 5 PM ET.

• Must be available for 40 hours per week, Monday through Friday, with an 8-hour daytime schedule based on the time zone.

• Exceptional written and verbal communication skills, capable of understanding and conveying complex information.

• Consistently achieve over 95% quality accuracy.

• Ability to communicate effectively with management regarding workload, production expectations, and deliverables.

• Capacity to thrive in a fast-paced work environment.

• Proficiency in managing and meeting deadlines.

• Participation in all required training is mandatory.

• Must provide a dedicated and secure workspace.

• High-speed internet access and an appropriate office setup are required.

🏝️ Benefits

• Consideration for discretionary bonuses.

• Overtime pay for non-exempt employees for hours exceeding 40 per week, or as mandated by applicable state law.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Disability insurance options.

• Life insurance benefits.

• 401(K) savings plan offerings.

• Paid family leave policy.

• Nine paid holidays each year.

• 17-27 days of Paid Time Off (PTO) annually, based on level and tenure.