Certified Risk Adjustment Coder

Job Summary

Bringing expertise in medical coding and Hierarchical Condition Categories, the full-time Certified Risk Adjustment Coder will conduct medical record reviews, ensure compliance with documentation standards, and identify opportunities for quality improvement in a remote setting.

Key responsibilities

• Conduct medical records reviews and accurate diagnosis code abstraction following official coding guidelines
• Utilize HHS' Risk Adjustment Model to verify accuracy of Hierarchical Condition Categories from ICD-10-CM codes
• Perform documentation audits to identify gaps in risk adjustment data and collaborate with team members on compliance education

Required qualifications

• High school diploma
• 2+ years of experience with relevant Coding Certifications (CPC, CCS-P, CCS-H, RHIT, RHIA, or CRC certification)
• Experience with medical documentation audits and proficiency in ICD-10-CM coding guidelines
• Familiarity with CMS regulations for Risk Adjustment programs
• Computer competency with Excel, MS Word, and Adobe Acrobat