VMG Risk Adjustment Coder - CRC Remote

Position: VMG Risk Adjustment Coder - CRC within 6 months! (Remote)

VMG Risk Adjustment Coder – CRC within 6 months! (Remote)

Role at Virtua Health.

Position Summary

Evaluates and analyzes medical records for proper documentation and correct diagnosis (ICD‑10‑CM) codes for a wide variety of clinical cases and services for risk adjustment models (e.g., HCC, CDPS, HHS risk adjustment). CRCs review provider documentation and communicate coding opportunities for HCC coding so that disease processes are coded accurately to follow risk adjustment models.

Position Responsibilities

• Evaluates and analyzes medical records for proper documentation.
• Identifies and communicates coding deficiencies to clinicians to improve documentation for accurate risk adjustment coding.
• Provides ongoing training and education to clinicians and physicians during 1:1, physician group, performance improvement, and ad hoc meetings.
• Manages and trends data collection for HCC and other risk coding.
• Performs data mining from data captured through risk adjustment coding.
• Works with Manager and Director of VMG Quality Department to strategize and prioritize chart reviews and education.
• Assists with the development of action plans to improve documentation.
• Completes chart reviews for various Value‑Based Programs focusing on annual review of suspect chronic conditions; utilizes payer portals as necessary.

Position Qualifications

• Minimum of two years records coding experience or equivalent.
• Ability to perform functions in a Microsoft Windows environment.
• Detail oriented and performs tasks at a high level of accuracy.
• Ability to make sound decisions.
• Excellent communication and teamwork skills.
• Previous experience with an electronic health record system.
• Knowledge of anatomy, pathophysiology, and medical terminology necessary to correctly code diagnoses.
• Understanding of medical coding guidelines and regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
• Local candidates preferred due to occasional onsite requirements.
• HCC experience strongly preferred.

Required Education

• High School Diploma or GED required.
• Knowledge of anatomy & physiology / medical terminology required.

Training / Certification / Licensure

• CPC required.
• Risk Adjustment Coder Certification (CRC) required or must be obtained within six months of hire.

Seniority Level

Entry level

Employment Type

Full‑time

Job Function

Health Care Provider

Industries

Hospitals and Health Care

Location & Salary

New Jersey, United States – Remote. $55,000.00–$65,000.00 per year.

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