Risk Adjustment Coding Specialist

Job Summary

Reviewing medical records and validating diagnosis information, the full-time Risk Adjustment Coding Specialist will work remotely to ensure accurate risk adjustment coding while adhering to established guidelines and departmental procedures.

Key Responsibilities

• Review medical records to identify clinical documentation supporting diagnosis reporting and risk adjustment activities
• Validate diagnosis codes selected by providers to ensure documentation supports accurate and compliant coding
• Collaborate with providers and internal stakeholders to obtain clarification regarding documentation requirements

Required Qualifications

• High school diploma or GED required
• Active coding credential through AAPC or AHIMA required; CRC preferred
• Minimum one year of healthcare, outpatient, coding, or related medical experience preferred
• Working knowledge of ICD-10-CM coding conventions and medical terminology
• Foundational understanding of anatomy, physiology, disease processes, and pharmacology