Risk Adjustment Coder
2 weeks ago
Atos Taguig, National Capital Region, Philippines
2 weeks ago Be among the first 25 applicants
Recruitment Business Partner | Hiring Team Leads for Invoicing and InsuranceWork Setup: Full onsite during training (2 weeks to 1 month), then transitions to WFH
Shift Schedule: Night shift during training, then shifts to midshift (1:00 PM – 10:00 PM) afterward
Job Summary- We are seeking newly certified coders to join our team. The ideal candidate will be responsible for reviewing medical records to identify, code, and validate diagnoses based on risk adjustment models such as HCC (Hierarchical Condition Categories). The coder must ensure accuracy, compliance, and completeness in coding to support optimal reimbursement and risk score accuracy.
- Registered Nurse with active Philippine license (with or without clinical experience)
- Certification: CPC, CRC (Certified Risk Adjustment Coder), or equivalent coding certification is required.
- Experience: at least 1 year Risk Adjustment experience, newly certified medical coders are most welcome
- Knowledge: Strong understanding of ICD-10-CM coding, HCC risk adjustment models, and medical terminology.
- Attention to Detail: Strong analytical and problem-solving skills to ensure accuracy in coding and documentation review.
- Work Ethic: Ability to work independently and meet productivity and quality targets in a fast-paced environment.
- Analyze medical records to assign accurate ICD-10-CM codes according to risk adjustment guidelines (HCC, RxHCC, CDPS, etc.).
- Ensure all documented diagnoses are supported by proper clinical documentation.
- Identify and capture chronic conditions that impact risk scores.
- Adhere to official coding guidelines, CMS regulations, and internal policies.
- Ensure all coding meets risk adjustment and compliance standards to prevent coding discrepancies and audits.
- Maintain a high level of coding accuracy to meet organizational quality standards.
- Stay updated on risk adjustment methodologies, coding guidelines, and industry changes.
- Participate in training sessions, webinars, and certifications to maintain expertise in risk adjustment coding
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