HCC / Risk Adjustment Medical Coders

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

📋 Description

• Review and accurately code medical records and encounters in accordance with diagnoses and procedures relevant to Risk Adjustment and HCC coding standards.

• Ensure that coding aligns with ICD-10-CM, CMS-HCC, and other pertinent coding regulations.

• Validate the completeness, precision, and integrity of coded information.

• Identify and rectify discrepancies between clinical documentation and diagnosis coding.

• Keep abreast of coding guidelines, rules, and regulations pertaining to Risk Adjustment and HCC coding.

• Comply with HIPAA regulations to uphold data security and maintain patient confidentiality.

• Collaborate with healthcare providers, physicians, and team members to clarify documentation and resolve coding inquiries.

• Engage in coding education and training programs.

• Prepare and submit reports on coding activities, accuracy, issues, or trends.

• Assist in conducting internal and external coding audits.

• Identify opportunities for enhancing processes and efficiency.

• Provide recommendations for improving coding documentation and accuracy.

⛳️ Requirements

• A minimum of CPC or CCS certification from AHIMA or AAPC is mandatory.

• CPC-A (Apprentice) certification will not be accepted.

• CRC (Certified Risk Adjustment Coder) certification is a considerable advantage.

• At least one to two years of experience in Risk Adjustment and HCC coding within a healthcare environment.

• Strong knowledge of ICD-10-CM coding guidelines and the CMS-HCC risk adjustment methodology.

• Familiarity with electronic health record (EHR) systems and coding software.

• Exceptional attention to detail and analytical abilities.

• Capability to work independently.

• Strong communication and interpersonal skills for effective collaboration with medical professionals and team members.

• Understanding of compliance and confidentiality regulations, including HIPAA.

• Availability to work from 6 AM to 6 PM EST.

• Minimum commitment of 20 hours per week, Monday through Friday.

• Access to a Windows-based laptop or desktop with Windows Professional Edition (Windows Pro).

• A reliable high-speed internet connection.

• Windows Home Edition systems do not meet the role's security requirements.

🏝️ Benefits

• Bring Your Own Device (BYOD) policy.

• Minimum commitment of 20 hours per week; preference for candidates willing to commit to 40 hours per week.