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 pertaining to diagnoses and procedures in accordance with Risk Adjustment and HCC coding guidelines.

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

• Validate and maintain the completeness, accuracy, and integrity of coded data.

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

• Keep abreast of the latest coding guidelines, policies, and regulations concerning Risk Adjustment and HCC coding.

• Comply with all regulations related to compliance and HIPAA to safeguard data security and patient confidentiality.

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

• Engage in coding education and training programs to enhance coding proficiencies and knowledge.

• Prepare and submit reports regarding coding activities, coding accuracy, and any pertinent coding-related issues or trends.

• Assist in both internal and external coding audits to ensure the quality and compliance of coding practices.

• Identify opportunities to enhance efficiency and process improvements within the coding workflow.

• Provide recommendations to improve coding documentation and accuracy.

⛳️ Requirements

• A minimum of CPC or CCS certification from AHIMA or AAPC is mandatory. Higher-level certifications like CRC (Certified Risk Adjustment Coder) are a considerable advantage. CPC-A (Apprentice) certification will not be accepted for this role.

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

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

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

• Exceptional attention to detail, analytical abilities, and the capacity to work independently.

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

• Knowledge of compliance and confidentiality regulations, including HIPAA.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Supportive work environment that fosters teamwork and collaboration.

• Flexible work arrangements to promote work-life balance.