Review and accurately code medical records and encounters according to Risk Adjustment and HCC guidelines. Collaborate with healthcare providers to resolve coding queries and ensure data integrity and compliance.
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.
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.
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.
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.
Candidates must hold a CPC or CCS certification from AHIMA or AAPC and possess at least one to two years of experience in Risk Adjustment and HCC coding. Applicants are required to have a Windows Pro laptop and high-speed internet for this BYOD position.
