Risk Adjustment Coder

The Risk Adjustment Coder collaborates directly with physicians, office staff, and support departments to review medical records and clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. The role focuses on collecting and reviewing documents supporting quality and risk adjustment initiatives to improve quality of care.

Responsibilities include reviewing medical records, patient history, physician notes, and reports to ensure diagnosis codes are accurate and supported per ICD-10-CM guidelines, querying providers for unsubstantiated codes, assessing severity of illness, identifying opportunities to improve risk adjustment score accuracy, providing feedback on documentation quality, identifying coding trends and training needs, attending meetings, and other duties as assigned.

Knowledge and skills required include advanced medical terminology, anatomy, physiology, disease processes, experience with electronic medical records, ability to manage workload and deadlines with minimal supervision, strong communication, follow-up, organizational skills, accuracy, efficiency, and dependability.

Education and experience requirements:

• High School Diploma or GED
• Coding Certificate required; APPC or AHIMA preferred
• Certified Risk Coder (CRC) required or 3-5 years of risk adjustment coding experience
• Minimum 2 years experience in a primary care environment
• Proficiency with Microsoft Office Suite (Excel formulas, charts, tables)
• Strong knowledge of medical coding (CPT/ICD-9 & ICD-10) and third party procedures

This is a remote, full-time, 6-month contract position.