Risk Adjustment Coder
Hours of Work: 8 AM to 4:30 PM
Days Of Week: Monday - Friday
Work Shift:
Job Description:
Your Job: The Risk Adjustment Coder works in a collaborative effort directly with physicians and their office staff and other support departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. The major focus of the position is to collect and review documents to support the organization's quality and risk adjustment initiatives, which results in improving quality of care.
Your Job Requirements:
- High School Diploma or GED required.
- Two (2) + years' experience in a primary care environment is required.
- Coding Certificate required. AAPC or AHIMA coding certified preferred.
- CRC (certified risk coder) is required, or minimum of 3-5 years' experience in risk adjusting coding in lieu of certificate.
- Strong knowledge of Microsoft Office Suite (Excel-basic mathematical formulas, charts, tables).
- Strong medical coding and third party operating procedures and practices.
- Knowledge of CPT/ICD-9 & 10 & Medical Terminology.
Your Job Requirements:
- Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
- Reviews for clinical indicators and query providers to capture the severity of illness of the patient.
- Reviews of medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify whether the diagnosis codes are supported by the documentation and ensure with ICD-10-CM guidelines for coding and reporting and the diagnosis codes for each chronic or major medical condition have been captured correctly.
- Provides feedback to internal clients on examples of documentation and physician self-coding that do not meet quality standards, examples of missed operations missed opportunities and Identifies clinical coding and documentation trends and training needs to improve the quality of documentation to reflect our patients' health data.
- Demonstrated ability to utilize a variety of electronic medical records systems.
- Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision.
- Other duties as assigned and modified at manager's discretion.
Methodist Medical Group is the North Texas physician organization affiliated with Methodist Health System. Our fast-growing network of providers includes more than 92 MMG ambulatory clinics, an urgent care clinic, and a virtual care service known as MethodistNOW. Our employees enjoy not only competitive salaries but also the outstanding benefits package of Methodist Health System, which includes medical, dental, and vision insurance; a matched retirement plan; an employee wellness program; and more. The opportunities for career growth are equally generous. Our affiliation means being part of an award-winning workplace:
- Newsweek's America's Most Admired Workplaces 2026
- Glassdoor's Best-Led Companies 2025
- Fortune's Best Workplaces in Health Care 2025
- Great Place to Work Certified 2026-2026
- Glassdoor's Best Places to Work 2025
- TIME's Best Companies for Future Leaders 2025
- Military Friendly Gold Employer 2025
- Newsweek's America's Greatest Workplaces for Mental Well-Being 2025
- Becker's Healthcare Top Places to Work in Healthcare 2025
- Newsweek's Greatest Workplaces 2025