Remote - HCC / Risk Adjustment Medical Coders

United StatesRemoteFull-timemid

OtherRisk

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Quick Summary

Key Responsibilities

Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines. Ensure coding is consistent with ICD-10-CM, CMS-HCC,

Requirements Summary

We are seeking experienced Medical Coders with a strong background in Risk Adjustment and Hierarchical Condition Category (HCC) coding.

Technical Tools

OtherRisk

Responsibilities

~1 min read

→Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.
→Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines.
→Validate and ensure the completeness, accuracy, and integrity of coded data.
→Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding.
→Stay up-to-date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding.
→Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality.
→Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries.
→Participate in coding education and training programs to enhance coding skills and knowledge.
→Prepare and submit reports related to coding activities, coding accuracy, and any coding-related issues or trends.
→Assist in internal and external coding audits to ensure the quality and compliance of coding practices.
→Identify opportunities for process improvement and efficiency in the coding process.
→Offer suggestions to enhance coding documentation and accuracy.

Requirements

~1 min read

Minimum CPC or CCS certification from AHIMA or AAPC is required. Higher-level certifications such as CRC (Certified Risk Adjustment Coder) is a significant advantage. CPC-A (Apprentice) certification will not be considered for this position.
Minimum one to two years of experience in Risk Adjustment and HCC coding in a healthcare setting.
Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology.
Familiarity with electronic health record (EHR) systems and coding software.
Excellent attention to detail, analytical skills, and ability to work independently.
Strong communication and interpersonal skills for collaboration with medical professionals and team members.
Understanding of compliance and confidentiality regulations, including HIPAA.