We are seeking an experienced Risk Adjustment Coder to review medical records, identify accurately documented HCC conditions, and assign appropriate ICD-10-CM codes in accordance with CMS guidelines.
Key Responsibilities
- Review patient charts for risk-adjusted diagnoses and supporting documentation.
- Apply CMS-HCC/V28, MEAT, and ICD-10-CM guidelines.
- Identify documentation gaps and support provider queries.
- Perform prospective and retrospective chart reviews.
- Maintain high coding accuracy and documentation quality.
- Participate in quality audits and feedback.
- Requirements
- 2+ years of hands-on HCC/Risk Adjustment coding experience.
- CRC preferred; CPC with robust HCC experience also considered.
- Strong knowledge of CMS-HCC/V28 and ICD-10-CM.
- Experience with MEAT criteria and medical record review.
- Good understanding of U.S. healthcare coding practices.
- Willingness to work U.S.-aligned night shifts.
- Preferred: Experience with major EHR systems, provider groups, health plans, ACOs, or value-based care.