HCC | Risk Adjustment Coder

Integrated Resources Inc

Job Title: HCC | Risk Adjustment Coder
Location: Newark, NJ (100% Remote)
Duration: 6 months (possible extension)
Pay Rate: $30 - $35/hr. on W2

Schedule: Regular Business Hours.

Important Details:

Candidates can be located in any one of the five states: NJ, NY, PA, CT, and DE
You will be required to travel for the pickup and return of equipment, and/or laptops that need servicing.

Job Summary:

Responsible for reviewing, auditing, coding, and analyzing medical records to ensure accurate diagnosis documentation and HCC abstraction. Supports Medicare, Medicaid, Commercial Risk Adjustment programs, and RADV audits while ensuring compliance with ICD-10 coding guidelines and risk adjustment regulations.

Key Responsibilities

Review medical records for coding accuracy, completeness, and compliance
Abstract and validate HCC diagnoses using ICD-10, CPT, and HCPCS coding systems
Support Medicare Advantage, Medicaid, Commercial, and ACA risk adjustment initiatives
Participate in coding audits, chart reviews, and quality improvement activities
Provide coding guidance and education to internal stakeholders
Maintain productivity and accuracy standards

Requirements

RHIT, CPC, or CCS certification required
2-5 years of Medical Coding experience
Minimum 2 years of Health Insurance, Chart Audit, Risk Adjustment, or Utilization Review experience
Strong knowledge of ICD-10, CPT, HCPCS, and medical terminology
Proficiency with Microsoft Office (Word, Excel)
Strong analytical, communication, and problem-solving skills

Preferred

Bachelor's Degree
Experience with HCC Coding, RADV Audits, Risk Adjustment, or Quality Chart Reviews

Ideal Candidate

Experienced Medical Coder with strong HCC/Risk Adjustment knowledge, chart auditing experience, and expertise in ICD-10, CPT, and HCPCS coding within a health plan or insurance environment.

Apply

Vacancy posted 3 days ago

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