Coding Consultant

CPC, CCS, RHIT, or CRC certification required. Minimum 3-5 years of medical coding experience, preferably in risk adjustment or HCC coding. High school diploma required; Associate’s or Bachelor’s degree preferred. Strong knowledge of CMS-HCC models, diagnosis coding guidelines, and RAF scoring. High attention to detail and accuracy. Ability to work independently in a remote, deadline-driven environment. Proficiency with EMR/EHR systems and coding platforms. Strong written communication skills.

Assign diagnosis codes by reviewing medical records. Conduct PEP coding and concurrent coding workflows. Document coding rationales clearly. Maintain adherence to CMS requirements and risk adjustment integrity. Maintain a coding accuracy score of 95% or higher. Participate in internal audits and peer reviews. Ensure compliance with documentation and CMS risk adjustment standards. Flag documentation inconsistencies for clinical review. Complete assigned coding volumes within productivity targets. Utilize IntusCare's IRIS tools for coding tasks. Collaborate with IRIS team members for clarification. Communicate coding questions to internal contacts.