Senior Risk Adjustment Coder

What You'll Do

• Conduct advanced retrospective reviews for risk adjustment and HCC capture
• Review highly complex clinical documentation and assign accurate ICD-10-CM codes
• Ensure coding practices align with CMS, client, and regulatory standards
• Identify documentation gaps and coding opportunities
• Maintain productivity standards of 4-10 charts per hour based on chart complexity
• Consistently achieve and maintain 95% or greater quality accuracy
• Participate in coding quality audits and escalation reviews
• Provide guidance and support to junior coders when appropriate
• Assist in calibrations, education sessions, and coding best practice discussions
• Serve as a subject matter expert for risk adjustment coding initiatives

What We're Looking For

• Active CPC-A, CCA, CPC, CCS, CRC, RHIT, or RHIA credential
• 5+ years of dedicated risk adjustment/HCC coding experience
• Expert-level ICD-10-CM coding knowledge
• Strong understanding of CMS-HCC and Medicare Advantage risk adjustment methodologies
• Experience reviewing complex specialty and chronic condition documentation
• Proven history of meeting productivity and quality expectations
• Ability to work independently with minimal oversight
• Available to start immediately

Nice to Have

• Multiple coding certifications
• Experience performing coding audits or quality reviews
• Experience mentoring or training coders
• Medicare Advantage, ACO, Value-Based Care, or Population Health experience

Benefits Offered

• Weekly pay
• Medical, dental, and vision coverage
• Voluntary life and AD&D coverage
• Fully remote flexibility
• Opportunity for permanent employment based on performance and business need
• Flexible scheduling with part-time and full-time options available