Certified Risk Adjustment Coder

Job Summary

Working remotely in a full-time capacity, the Certified Risk Adjustment Coder will perform medical record reviews, ensure compliance with Medicare Risk Adjustment metrics, and document findings to enhance coding accuracy and provider education.

Key responsibilities:

• Conduct medical record reviews to determine appropriate ICD-10-CM coding and billing compliance
• Document detailed audit findings and communicate deficiencies to improve provider documentation
• Provide actionable solutions to enhance coding quality and support risk adjustment metrics

Required qualifications:

• AAPC Certified Professional Coder and/or Certified Risk Adjustment Coder (CRC)
• Completion of an accredited certified coding specialist program
• 2+ years of clinic or hospital experience and/or managed care experience
• 1+ years of experience in Risk Adjustment and HEDIS/Stars
• Comprehensive knowledge of ICD-10-CM codes and CMS documentation requirements