HCC Coder - Medical Records Coding (REMOTE)

Required Skills & Experience Certified coder (CPC, CCS, CRC, CCA, or equivalent certification)
Strong ICD-10-CM coding experience and medical record review background
Knowledge of Risk Adjustment and HCC coding methodologies
Experience reviewing physician documentation and assigning accurate diagnosis codes
Strong understanding of medical terminology, anatomy, physiology, and disease processes
Ability to interpret complex clinical documentation with high accuracy and productivity
Familiarity with CMS guidelines and Medicare Advantage requirements
Nice to Have Skills & Experience Medicare Advantage Risk Adjustment experience
Experience working with CMS-HCC models
CRC (Certified Risk Adjustment Coder) certification
Experience with EMRs and coding software platforms
Background in a health plan, physician practice, hospital, or revenue cycle environment
Audit and quality assurance experience
Job Description Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.
Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence. This role offers the opportunity to work closely with providers and healthcare teams to improve coding accuracy, enhance documentation quality, and support critical risk adjustment initiatives. Candidates with Medicare Advantage and HCC coding experience will be highly sought after.
Day-to-Day: Review medical records, physician documentation, and clinical data to identify reportable diagnoses
Assign accurate ICD-10-CM diagnosis codes based on coding guidelines and documentation
Identify diagnoses impacting Risk Adjustment and HCC reporting
Validate coded diagnoses against clinical evidence and documentation standards
Perform prospective and retrospective chart reviews
Identify missed, unsupported, or incorrectly coded diagnoses
Ensure compliance with CMS, Medicare Advantage, HIPAA, and organizational coding requirements
Participate in coding audits and quality assurance initiatives
Communicate coding and documentation questions with providers and clinical staff
Stay up to date on ICD-10, HCC, and CMS regulatory changes
Compensation: Compensation: $23- $28 per hour.
Exact compensation may vary based on several factors, including skills, experience, and education.
Benefit packages for this role may include healthcare insurance offerings and paid leave as provided by applicable law.

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