Risk Adjustment Coder

The Risk Adjustment Coder is responsible for reviewing and accurately assigning diagnosis codes to medical records in accordance with ICD-10-CM coding guidelines, CMS-HCC Risk Adjustment methodologies, and client-specific requirements. This role ensures complete and compliant documentation to support accurate risk score capture while maintaining high standards of coding quality, productivity, and regulatory compliance.

Key Responsibilities

• Review outpatient and physician medical records to identify and assign accurate ICD-10-CM diagnosis codes.
• Apply CMS-HCC Risk Adjustment coding guidelines and ensure proper Hierarchical Condition Category (HCC) capture.
• Validate medical documentation to ensure diagnoses are fully supported and compliant with coding standards.
• Maintain coding accuracy while meeting productivity and quality benchmarks.
• Stay current with annual ICD-10-CM, CMS-HCC, and regulatory guideline updates.
• Participa...

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