HCC Risk Adjustment Coder

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

📋 Description

• Evaluate medical records through PDF or an electronic medical record system.

• Extract and assign CPT/HCPCS, ICD, and modifier codes.

• Investigate and resolve assigned coding projects.

• Document information requested from medical records.

• Assess valid encounters, including legibility and valid signature criteria.

• Identify legitimate face-to-face encounters.

• Review medical record charts for coding compliance.

• Validate coding according to payor guidelines and client coding protocols.

• Achieve daily production targets while maintaining an average accuracy rate of 95% consistently.

• Participate in conference calls as needed to share information and provide feedback.

⛳️ Requirements

• Active certified coder certification (CRC, CPC, CPMA, CCS - P) through AHIMA or AAPC.

• Possess at least one active AAPC or AHIMA certified program with the corresponding professional credential (RHIT, CPC, CCS, CPC-H, etc.); must be active and in good standing with the certifying organization.

• High School diploma required.

• A minimum of three (3) years of coding experience (recent hands-on production) in both areas.

• At least one (1) year of specialized experience in Medicare Risk Adjustment.

• A minimum of four (4) years of experience as a certified coder/auditor across multiple specialties.

• At least two (2) years of experience in risk adjustment and provider evaluation and management (E/M).

• Capability to code ICD-10, modifier, and CPT/HCPCS.

• Proficient in computer usage, including MS Windows, MS Office, and the Internet.

• Access to high-speed Internet.

• Understanding of HIPAA, privacy, security, and confidentiality regulations.

• Strong clinical knowledge related to chronic illness management, evaluation, assessment, and treatment (MEAT).

• Extensive familiarity with ICD-10-CM outpatient diagnosis coding guidelines.

• Preferred knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements.

• Dependability and a commitment to meeting tight deadlines.

• Self-discipline to work remotely without direct supervision.

• Exceptional attention to detail and thoroughness.

• Strong organizational, interpersonal, and customer service skills.

• Proficient written and oral communication skills.

• Analytical capabilities.

• Comprehensive knowledge of medical anatomy and terminology.

• Understanding of the medical and business aspects of healthcare operations.

• Ability to interpret Medicare, Medicaid, and third-party payer guidelines.

• Capacity to multitask in a fast-paced setting.

• Advanced computer skills including MS Office, Excel, Word, Internet, and email.

• Capability to navigate internal networks and external Internet data portals.

• Strong organizational skills and the ability to work independently.

• Ability to communicate effectively with various levels of personnel, medical professionals, clients, the public, and other business representatives.

• Excellent verbal and written communication skills.

• Quick learning abilities.

• Aptitude for managing multiple projects/accounts simultaneously with frequent interruptions.

• Preferred credentials include CPC, CPMA, and CRC.

• A college degree is preferred.

🏝️ Benefits

• 100% REMOTE - Work from home.

• Flexible working schedule.

• Paid training.