
Medical Coding Specialist
10 hours ago
At a leading healthcare organization, we are seeking newly certified coders to fill a vital role. 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.
Main Responsibilities:- Assign accurate ICD-10-CM codes according to risk adjustment guidelines (HCC, RxHCC, CDPS, etc.).
- Evaluate medical records to ensure all documented diagnoses are supported by proper clinical documentation.
- Capture chronic conditions that impact risk scores.
- Adhere to official coding guidelines, CMS regulations, and internal policies.
- Registered Nurse with active license (with or without clinical experience).
- CPC, CRC (Certified Risk Adjustment Coder), or equivalent coding certification is required.
- Strong understanding of ICD-10-CM coding, HCC risk adjustment models, and medical terminology.
Maintain high levels of coding accuracy to meet organizational quality standards. Stay updated on risk adjustment methodologies, coding guidelines, and industry changes.
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