HCC Coder

HCC Coder - REMOTE

This role performs advanced ICD‑10‑CM coding and risk‑adjustment abstraction across HCC, RxHCC, and ESRD models. You will review medical records, validate diagnosis capture, and ensure compliance with Medicare , ICD‑10‑CM , and client‑specific guidelines. Success in this role requires strong analytical skills, high accuracy, independent productivity, and deep expertise in Medicare Advantage risk‑adjustment coding .

• Fully remote
• Equivalent of 40 hour work week, flexible schedule
• Contract: October - January
• Pay: $22/hr
• *2 full years of HCC Coding experience required, and the CRC is highly preferred but will accept CPC’s, Medicare Advantage experience is a must

⭐ Essential Responsibilities

• ICD‑10‑CM Code Abstraction — Review and analyze medical records to assign accurate ICD‑10‑CM codes mapped to HCC, RxHCC, and ESRD models.
• Guideline Compliance — Apply Medicare, ICD‑10‑CM, and client‑specific coding rules; interpret coding guidelines to ensure precise code selection.
• Risk‑Adjustment Documentation Review — Follow all Risk Adjustment Data Abstraction rules and validate documentation meets MEAT criteria.
• Quality & Productivity Performance — Maintain ≥95% coding quality and meet project‑defined productivity benchmarks.
• Privacy & Security Compliance — Protect PHI and adhere to all organizational privacy, security, and confidentiality standards.
• Audit & Data Integrity — Ensure accuracy within EMRs, billing systems, and abstraction platforms; reconcile discrepancies as needed.
• Technology & Tools Utilization — Use EMRs, billing systems, abstraction platforms, Excel, Outlook, and current ICD‑10‑CM coding references effectively.
• Professional Communication — Communicate clearly and professionally in both written and verbal formats.
• Independent Remote Work — Work autonomously in a remote environment with reliable internet, phone access, and up‑to‑date coding materials.
• Additional Duties — Perform other responsibilities as assigned by leadership.

⭐ Required Qualifications

• Active coding certification through AAPC or AHIMA (no apprenticeship designations).
• Acceptable credentials: CRC and CPC ; CRC strongly preferred .
• 2+ years of HCC coding experience .
• Medicare Advantage experience required .
• Proficiency with EMRs, billing systems, and abstraction platforms.
• Ability to use Excel (basic formulas, data entry) and Outlook (email management, scheduling).
• Strong analytical, decision‑making, and deadline‑management skills.
• Ability to work a 40‑hour work week with a flexible schedule.

Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements