Certified Risk Adjustment Coder

Job Summary

Working remotely in a full-time capacity, the Certified Risk Adjustment Coder will support accurate coding practices by performing first-pass reviews of member medical records to identify active conditions that map to risk values, ensuring documentation accuracy and compliance within the Risk Adjustment & Quality Division.

Key responsibilities

• Maintain compliance with CMS risk adjustment diagnosis coding guidelines
• Perform comprehensive first-pass reviews of medical records and physician assessment forms (HCC coding)
• Assist with the intake and quality assurance of medical records as necessary

Required qualifications

• Associate's degree or equivalent work experience (2 years of professional work experience)
• 1 year of progressive medical coding and healthcare experience required
• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA)
• Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year of training completion
• Understanding of ICD-10 coding standards required