Risk Adjustment Coder
Fully Remote - US
Risk Adjustment Coder
Full Time • Fully Remote - US
Job Description: Risk Adjustment Coder
Job Summary
We are seeking an experienced and certified Risk Adjustment Coder to perform medical record reviews, coding validation, and audit activities in accordance with applicable CMS guidelines. The ideal candidate will have strong knowledge of ICD-10-CM coding, risk adjustment methodologies, medical record documentation, and regulatory compliance requirements.
Key Responsibilities
- Review medical records to identify and validate reportable diagnoses.
- Perform first-pass and second-pass coding reviews and audits, as applicable.
- Ensure accurate diagnosis code assignment in accordance with ICD-10-CM guidelines and CMS requirements.
- Verify that coded diagnoses are supported by appropriate medical record documentation.
- Identify coding discrepancies, documentation gaps, and potential compliance issues.
- Maintain accurate audit documentation and record findings, errors, and recommendations.
- Follow established coding guidelines, quality standards, and compliance protocols.
- Meet productivity, accuracy, and quality performance targets.
- Collaborate with internal teams to resolve coding discrepancies and support audit requirements.
This is a remote position.
Empowering the Future of Healthcare
The healthcare Industry is on the brink of a paradigm shift where patients are increasingly being viewed as empowered consumers, utilizing digital technologies to better understand and manage their own health. As a result, there is a growing demand for a range of patient-centric services, including personalized care that is tailored to each individual's unique needs, health equity that ensures access to care for all, price transparency to make healthcare more affordable, streamlined prior authorizations for medications, the availability of therapeutic alternatives, health literacy to promote informed decision-making, reduced costs, and many other initiatives designed to improve the patient experience.
ClinDCast is at the forefront of shaping the future of healthcare by partnering with globally recognized healthcare organizations and offering them innovative solutions and expert guidance. Our suite of services is designed to cater to a broad range of needs of healthcare organizations, including healthcare IT innovation, electronic health record (EHR) implementation & optimizations, data conversion, regulatory and quality reporting, enterprise data analytics, FHIR interoperability strategy, payer-to-payer data exchange, and application programming interface (API) strategy.
(if you already have a resume on Indeed)