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Medical Coder- Risk Adjustment

L5

insight globalTampa, FL9 days ago

Occupations

Health Information Technologists and Medical RegistrarsMedical Records SpecialistsHealth Informatics Specialists

Industries

All Other Miscellaneous Ambulatory Health Care ServicesGeneral Medical and Surgical HospitalsOffices of Physicians
Medical Coder - Risk Adjustment Coding
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 modelsCRC (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
Apply now (opens in a new tab)
Apply now (opens in a new tab)

Level

SeniorL5

Location

Tampa, FL

Occupation

Health Information Technologists and Medical Registrars

Industry

All Other Miscellaneous Ambulatory Health Care Services

Posted

9 days ago

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