Responsibilities Review and analyze patient medical records, including provider documentation, diagnostic reports, and treatment plans
Assign accurate ICD-10-CM diagnosis codes in compliance with CMS-HCC risk adjustment guidelines
Ensure all coded diagnoses are supported by appropriate clinical documentation
Identify gaps, inconsistencies, or missing documentation and initiate provider queries when necessary
Maintain compliance with CMS, Medicare Advantage, and internal coding policies
Meet established productivity, accuracy, and quality assurance benchmarks
Utilize electronic medical record (EMR) systems and risk adjustment coding tools effectively
Participate in internal and external audits, training, and continuous education initiatives
Collaborate with providers and internal teams to improve documentation quality and coding accuracy
Job Qualifications 1–2+ years of experience in risk adjustment or HCC coding
Experience with Medicare Advantage, CMS audits, or retrospective chart reviews
Prior remote coding experience
Familiarity with coding quality audits and compliance reviews
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