Medical Coder with Risk Adjustment Coding Expert

4 weeks ago


Taguig, National Capital Region, Philippines GECO Philippines Inc. Full time
Job Title: Medical Coder with Risk Adjustment Coding

We are seeking a highly skilled Medical Coder with expertise in Risk Adjustment Coding to join our team at GECO Philippines Inc.

Key Responsibilities:
  • Accurately assign diagnosis codes following the Official ICD-10-CM Guidelines for Coding and Reporting.
  • Conduct thorough chart reviews using computer-assisted coding tools to assess, interpret, and apply appropriate coding principles.
  • Demonstrate a comprehensive understanding of CMS-HCC guidelines to ensure medical records align with standards.
  • Exhibit advanced knowledge of medical terminology, anatomy, and physiology to accurately assign diagnosis codes and capture supporting information from the medical record.
  • Effectively manage the quality and productivity of individual work, ensuring goals are met or exceeded.
  • Perform necessary administrative duties as directed by the Team Lead/Operations Lead/Quality Lead.
  • Consult with the Team Lead/Operations Manager or Subject Matter Expert (SME) in Coding as necessary to ensure accuracy and compliance.
Requirements and Qualifications:
  • Must hold and maintain an active certification as a Certified Professional Coder (CPC) and/or Certified Risk Adjustment Coder (CRC) through the American Academy of Professional Coders (AAPC).
  • Alternatively, a Certified Coding Specialist (CCS) and/or Certified Coding Specialist – Physician-based (CCS-P) through the American Health Information Management Association (AHIMA) is acceptable.
  • Associate Degree or equivalent HCC coding experience.
  • Proficient in computer use, including MS Windows, MS Office, and internet-based tools.
  • Proficient in the use of official ICD-10-CM coding books or encoder software, corresponding to the dates of service being reviewed.
Preferred Skills/Experience:
  • Knowledge of Hierarchical Condition Code (HCC) concepts.
  • Familiarity with HIPAA regulations, ensuring the protection of privacy, security, and confidentiality of medical records.
  • Understanding of the AMA format and CMS HCC Risk Adjustment coding, along with validation requirements.
  • EMR/EHR experience preferred.


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