New York Licensed 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 for compliance with CMS requirements and identify improvement opportunities in documentation and coding processes
• Maintain current knowledge of coding standards and regulations, supporting the Medicare Risk Adjustment team in provider education

Required Qualifications, Training, and Education

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