Medical Coder

Key ResponsibilitiesRecord Review: Read and analyze patient charts, medical histories, and provider notes to extract relevant clinical data.Diagnosis Coding: Assign precise and specific ICD-10-CM codes for chronic and high-risk conditions following official coding guidelines.Risk Adjustment Abstraction: Capture all reportable conditions that affect the Risk Adjustment Factor (RAF) score.Compliance & Quality: Maintain high accuracy and compliance with HIPAA and health plan requirements.Productivity: Meet daily or weekly chart review quotas and quality benchmarks set by the employer.

Requirements and Qualifications

Experience: 2 to 5+ years of core medical coding experience, with specific exposure to HCC or risk adjustment.

Certifications: Industry credentials like the Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS).Knowledge: Strong command of ICD-10-CM guidelines, human anatomy, medical terminology, and disease processes.Technical Skills: Familiarity with Electronic Health Records (EHR/EMR), abstraction software, and basic Microsoft Office tools