Risk Adjustment Medical Record Coder-4

TL;DR

Risk Adjustment Medical Record Coder-4 (HCC/ICD-10): Reviewing member medical records and physician assessment forms to identify documented conditions that map to risk values, with an accent on accurate, compliant CMS coding across Medicare Advantage, ACA, and Medicaid programs. Focus on performing first-pass reviews, validating documentation quality, and solving non-routine coding and analytical challenges independently.

Location: Remote within the USA, based in Chattanooga, Tennessee, working 8:00 a.m.–5:00 p.m. Eastern Time.

Company

A U.S. health insurance organization focused on compliant medical coding, quality improvement, and member care administration.

What you will do

• Perform comprehensive first-pass reviews of medical records and physician assessment forms for HCC coding.
• Identify and capture active diagnoses that map to risk adjustment values.
• Maintain compliance with CMS risk adjustment diagnosis coding guidelines.
• Support medical record intake and quality assurance activities.
• Participate in special projects and collaborate with colleagues through remote team channels.

Requirements

• Associate degree or equivalent experience; equivalent experience means at least two years of professional work experience.
• At least one year of progressive medical coding and healthcare experience.
• Professional coding certification from AHIMA or AAPC, such as CPC, CCS, RHIT, or RHIA.
• Experience with HCC coding, particularly in Medicare Advantage, ACA, or Medicaid programs.
• Proficiency in ICD-10 coding standards, Microsoft Office, analytical problem-solving, and written and verbal communication.
• Must be able to work remotely from the USA during the standard 8:00 a.m.–5:00 p.m. Eastern Time shift. The Certified Risk Adjustment Coder certificate must be obtained from AAPC within one year after training.

Culture & Benefits

• Remote day-shift work with structured standard hours.
• Independent work with ongoing collaboration and peer support.
• Continuous learning in an evolving healthcare and coding environment.
• Responsible use of AI-enabled tools supported by established workflows, templates, and policies.
• Opportunities to contribute to quality, compliance, and team capability.