Remote - HCC / Risk Adjustment Medical Coders

Pay Rate: $22/hr.

Candidates must be available to commit to a minimum of 20 hours per week, Monday through Friday. Preference will be given to candidates who can commit to a full-time schedule of 40 hours per week.

Important : This position follows a Bring Your Own Device (BYOD) policy. Candidates must have a Windows-based laptop/desktop with Windows Professional Edition (Windows Pro) and a reliable high-speed internet connection. Systems running Windows Home Edition are not compatible with the security requirements for this role.

Job Summary: We are seeking experienced Medical Coders with a strong background in Risk Adjustment and Hierarchical Condition Category (HCC) coding. The ideal candidate will hold at least a CPC or CCS certification from AHIMA or AAPC, and higher-level certifications are highly desirable. As a Medical Coder specializing in Risk Adjustment/HCC, you will play a crucial role in ensuring accurate and compliant coding for our healthcare organization.

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, 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

Qualifications

• 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.