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

$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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