Risk Adjustment, HCC Coder, Auditor

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

📋 Description

• Conduct scheduled quality assurance assessments for clients.

• Examine patient medical records to validate HCC code assignments and ensure complete and accurate code capture.

• Adhere to official ICD-10-CM and Risk Adjustment guidelines.

• Execute precise and thorough chart audits.

• Verify that diagnoses are accurate and comprehensive according to ICD-10-CM Guidelines for Coding and Reporting.

• Confirm codes to the highest specificity level documented in medical records.

• Report on quality outcomes.

• Monitor and analyze educational opportunities.

• Address client subject matter requirements.

• Offer educational support and training to coders and/or providers.

• Maintain an auditing accuracy rate of 95% or higher.

• Achieve agreed-upon productivity benchmarks.

• Collaborate effectively within a team environment.

• Adhere to patient-record confidentiality and system-security policies.

• Primarily work from a home office, with occasional travel to field sites as necessary.

⛳️ Requirements

• Valid AHIMA or AAPC coding credential is required.

• CRC (Certified Risk Adjustment Coder) is preferred.

• A minimum of 3 years of coding experience is required.

• A commitment of 30 hours per week is preferred.

• Experience in HCC coding is preferred.

• At least 2 years of remote work experience is recommended.

• Must not have coded 2025 ACA or HHS charts.

• Must be available for the entire project duration (January–April 2027).

• Must be legally authorized to work in the United States.

• Visa sponsorship is not available.

• Knowledge of health systems operations, reimbursement methodologies, and coding conventions is essential.

• Advanced understanding of HCC/risk adjustment, coding, and documentation requirements.

• Capability to perform accurate and comprehensive HCC/risk adjustment chart audits.

• Ability to identify and communicate trends in provider coding and documentation.

• Exceptional written and verbal communication skills.

• Strong attention to detail.

• Strong organizational, analytical, and problem-solving skills.

• Proficient time management abilities.

• Commitment to maintaining confidentiality and system security.

• Must uphold coding credential requirements.

🏝️ Benefits

• Competitive salary.

• Comprehensive benefits package.

• 401(k) plan with company match.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Life insurance.

• Short-term disability insurance.

• Long-term disability insurance.

• Paid time off (PTO) policy.

• Opportunity to work remotely from a home office.

• Equal opportunity employment.