HCC Coder

Remote Opportunity | Full-Time | Permanent/Direct Hire | Two Openings

Join a collaborative risk adjustment and clinical documentation integrity workflow as a Risk Adjustment HCC Coder supporting FQHC and value-based care populations. In this remote medical coding job, you will review medical records to validate HCC opportunities, confirm accurate ICD-10-CM coding, and determine whether diagnoses are supported by clinical documentation.

This remote Risk Adjustment Coder role is associated with the Baltimore, Maryland area, a dynamic healthcare hub known for its strong medical community and access to leading clinical and healthcare organizations.

• Work Arrangement: Remote
• Employment Type: Permanent/direct opportunity
• Schedule: 8-hour days, 5 shifts per week
• Hours: 40 hours per week
• Weekly Estimated Pay: $1,300-$1,550
• Openings: 2
• Clinical Focus: Risk adjustment, HCC coding, FQHC, Medicaid, Medicare, and value-based care
• Electronic Medical Record: eClinical
  
  Works experience is helpful but not required

• At least 1 year of experience in risk adjustment coding, HCC coding, medical coding, or a related healthcare coding role
• Certified Professional Coder (CPC) certification required
• Certified Risk Adjustment Coder (CRC) certification required
• Strong knowledge of ICD-10-CM coding guidelines and risk adjustment methodologies
• Experience reviewing clinical documentation to validate diagnoses and support accurate risk adjustment capture
• Ability to identify both missed HCC opportunities and unsupported diagnoses
• Understanding of Medicaid and Medicare risk adjustment programs
• Experience in an FQHC, primary care, ambulatory, or value-based care setting preferred
• Strong critical-thinking, communication, organization, and attention-to-details skills
• Ability to work independently in a remote environment while collaborating effectively with CDI and coding teams

• Review potential missed risk adjustment and HCC opportunities identified through clinical documentation review
• Validate diagnoses against the medical record and assign accurate ICD-10-CM codes
• Determine whether clinical documentation adequately supports each risk-adjusted diagnosis
• Identify unsupported diagnoses and opportunities that should not be captured based on the available documentation
• Recognize additional missed risk adjustment opportunities during medical record review
• Provide clear coding rationale and feedback to the CDI team regarding validated or unsupported opportunities
• Review documentation for appropriate diagnosis specificity and accurate HCC risk capture
• Apply applicable Medicaid and Medicare risk adjustment guidelines and methodologies
• Support quarterly risk adjustment reviews across assigned patient populations
• Collaborate with CDI partners to improve documentation quality, medical coding accuracy, and compliance

• 401K with Matching, Healthcare, Dental and Vision

We are an equal opportunity employer and value diversity across our organization. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.