Risk Adjustment Medical Record Coder (HCC)

TL;DR

Risk Adjustment Medical Record Coder (HCC): Performing first-pass reviews of member medical records to identify and capture active conditions that map to risk values with an accent on compliance and documentation accuracy. Focus on applying ICD-10 coding standards, utilizing AI-enabled tools for efficiency, and ensuring quality within Medicare Advantage and ACA programs.

Location: Must be based in the USA (Remote, day-shift 8am-5pm ET).

Company

hirify.global is a major health insurance provider dedicated to improving the health and quality of life of its members.

What you will do

• Perform comprehensive 1st pass reviews of medical records and physician assessment forms using HCC coding.
• Maintain strict compliance with CMS risk adjustment diagnosis coding guidelines.
• Assist with the intake and quality assurance of medical records.
• Leverage AI-enabled tools to enhance accuracy and efficiency in daily coding tasks.
• Participate in special projects as directed by management.

Requirements

• Must be based in the USA.
• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA).
• Minimum 1 year of progressive medical coding and healthcare experience.
• Understanding of ICD-10 coding standards.
• Ability to work independently in a remote environment during standard 8am-5pm ET hours.
• Must acquire the Certified Risk Adjustment Coder (CRC) certificate within one year of hire.

Culture & Benefits

• Supportive remote work environment with team engagement.
• Commitment to continuous learning and professional development.
• Culture that encourages responsible innovation and the use of AI tools.
• Standard full-time employment benefits.