REMOTE Risk Adjustment Coder

Job Description

Insight Global is hiring experienced and CPC certified Risk Adjustment Coding Specialist (HCC) to support Medicare Advantage risk adjustment initiatives. This role will focus primarily on concurrent outpatient coding reviews with additional support for retrospective coding projects. The ideal candidate has strong HCC coding expertise, experience working in Epic, and a proven track record of maintaining high-quality coding standards (96%).

Responsibilities:

-Perform concurrent reviews of outpatient medical records to accurately capture HCCs and chronic conditions.

-Support retrospective coding projects as needed.

Assign ICD-10-CM diagnosis codes in accordance with CMS risk adjustment guidelines.

Review provider documentation for coding accuracy, completeness, and compliance.

Utilize Epic EMR to review encounters and clinical documentation.

Identify documentation opportunities that support accurate risk adjustment capture.

Collaborate with coding, quality, CDI, and operational teams.

Meet established productivity and quality expectations.

Maintain a minimum 96% coding accuracy rate.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to View email address on click.appcast.io learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy:

Skills and Requirements

Must have an active Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)

Minimum 3 years of Risk Adjustment/HCC coding experience.

Experience coding in a Medicare Advantage environment.

Strong knowledge of:

HCC Coding

ICD-10-CM

CMS Risk Adjustment Guidelines

Outpatient coding practices

Experience using Epic EMR or similar

Demonstrated ability to maintain 96% or greater coding accuracy in a fast paced, high production environment

Must be able to work a fixed schedule within 6:00 AM-6:00 PM CST hours.

No weekend work or evening work permitted.