New York Certified Risk Adjustment Coder

Job Summary

A company is looking for a Risk Adjustment Coder.

Key Responsibilities

• Perform code abstraction of medical records, ensuring accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes
• Review medical records to validate documentation meets CMS requirements and identify improvement opportunities
• Support the Medicare Risk Adjustment team by educating providers on compliance and maintaining coding quality audits with a minimum accuracy of 95%

Required Qualifications, Training, and Education

• Must have at least three recent years of experience in HCC/Risk Adjustment and/or inpatient coding
• Hold relevant certifications such as CPC, CRC, RHIT, or RHIA from AAPC or AHIMA
• Strong knowledge of clinical terminology, disease processes, anatomy, physiology, and pharmacology
• Familiarity with claims processing procedures and state, federal, and Medicare regulations
• Must reside in New York, New Jersey, or Connecticut