Pennsylvania Licensed Risk Adjustment Coder

Job Summary

To support accurate risk adjustment coding and documentation initiatives, the full-time Pennsylvania Licensed Risk Adjustment Coder will analyze coding trends, perform retrospective chart reviews, assign ICD-10-CM diagnosis codes, and collaborate with providers and operational teams while working remotely.

Key Responsibilities

• Analyze Medicare Risk Adjustment (MRA) data to identify coding, documentation, and performance trends
• Conduct retrospective medical record audits to validate coding accuracy and documentation completeness
• Partner with providers and coding teams to improve coding performance and documentation practices

Required Qualifications

• Certified coding credential required (CRC, CPC, CCS, RHIT, RHIA, or equivalent preferred)
• Strong knowledge of Medicare Risk Adjustment (MRA) and HCC coding methodologies
• Proficiency in ICD-10-CM coding and medical record abstraction
• Experience conducting coding audits and quality reviews
• Understanding of CMS regulations and risk adjustment principles