HCC Risk Adjustment Coder

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Requirements:

• Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS) through AAPC and/or AHIMA.
• Minimum of 5 years coding experience with knowledge of Medicare and Commercial Risk Adjustment.
• Additional experience in facility coding and Health Plan Risk Adjustment Data Validation Audit is preferred.
• Strong organizational skills and advanced knowledge of medical terminology, anatomy, and pharmacology.

Responsibilities:

• Review medical records as needed and assist platform clients with backlogs.
• Work on clinical pends, aiming to clear them within 72 hours.
• Update training course material for medical record abstraction.
• Review training test scores and provide feedback.
• Maintain a 95% accuracy score on all submitted work.
• Conduct remote mentoring/coaching and client training as necessary.
• Manage workload reports and maintain ongoing communication with the clinical management team.