The Risk Adjustment Coder will serve as a coding resource for internal departments within Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation). Coders will be responsible for coding patient charts to capture hierarchical chronic conditions and assigning appropriate diagnosis codes from medical records within guidelines established by the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures.
- Quality standard is averaging 95% on monthly quality audit scores
- Production expectations are 4 charts per hour on average
- 100% remote, no travel.
- Must have an active coding certification and 0.5-3 years of coding experience:
o Full list of accepted certs
AHIMA (Verify at My AHIMA)
* CCS-P (Certified Coding Specialist -Phys based)
* CCS (Certified Coding Specialist)
AAPC (Verify at AAPC Credential Verification, CPC Certification Verification)
* CPC (Certified Professional Coder)
* CPC-A (Certified Professional Coder Apprentice)
* CPC-P (Certified Professional Coder Payer)
* CRC (Certified Risk Adjustment Coder)
- HCC/Risk Adjustment Coding experience
- ICD-10 proficiency/certification
- Production driven coding experience
- Must be able to commit to working 40+ hours per week and minimum of 10 hours of overtime, no part time jobs allowed
- Access to a private home office and high speed internet
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.