Required Skills & Experience
• Certified coder (CPC, CCS, CRC, CCA, or equivalent certification)
• Strong ICD-10-CM coding experience and medical record review background
• Knowledge of Risk Adjustment and HCC coding methodologies
• Experience reviewing physician documentation and assigning accurate diagnosis codes
• Strong understanding of medical terminology, anatomy, physiology, and disease processes
• Ability to interpret complex clinical documentation with high accuracy and productivity
• Familiarity with CMS guidelines and Medicare Advantage requirements
Nice to Have Skills & Experience
• Medicare Advantage Risk Adjustment experience
• Experience working with CMS-HCC models
• CRC (Certified Risk Adjustment Coder) certification
• Experience with EMRs and coding software platforms
• Background in a health plan, physician practice, hospital, or revenue cycle environment
• Audit and quality assurance experience
Job Description
Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC reporting.
Ideal candidates will have strong experience with medical record review, coding compliance, and CMS guidelines, ensuring all diagnoses are fully supported by clinical evidence. This role offers the opportunity to work closely with providers and healthcare teams to improve coding accuracy, enhance documentation quality, and support critical risk adjustment initiatives. Candidates with Medicare Advantage and HCC coding experience will be highly sought after.
Day-to-Day:
• Review medical records, physician documentation, and clinical data to identify reportable diagnoses
• Assign accurate ICD-10-CM diagnosis codes based on coding guidelines and documentation
• Identify diagnoses impacting Risk Adjustment and HCC reporting
• Validate coded diagnoses against clinical evidence and documentation standards
• Perform prospective and retrospective chart reviews
• Identify missed, unsupported, or incorrectly coded diagnoses
• Ensure compliance with CMS, Medicare Advantage, HIPAA, and organizational coding requirements
• Participate in coding audits and quality assurance initiatives
• Communicate coding and documentation questions with providers and clinical staff
• Stay up to date on ICD-10, HCC, and CMS regulatory changes
Compensation:
$23- $28 per hour.
Exact compensation may vary based on several factors, including skills, experience, and education.
Benefit packages for this role may include healthcare insurance offerings and paid leave as provided by applicable law.
...A leading freelance marketplace is seeking a talented 3D animator to create a photorealistic animation for a new soundbar. This remote freelance project requires immediate availability and involves developing visuals that emphasize audio performance. Candidates must have...
...Positions Contributions to Work Group : - We are seeking a UX/UI Researcher for the Shop Team. The UX Researcher will utilize their knowledge of human computer interactions and best user research practices to support the concept, prototype, test, and documentation of...
...Dunkin' - Immediate Baker Are you passionate about baking delicious treats and working in a dynamic team environment? Do you thrive in a fast-paced, time-sensitive role? Dunkin' is looking for a talented Baker to join our fun and loving team in Damariscotta...
...Junior Product Designer Join a remote-first Product team focused on creating intuitive digital experiences for customers managing a global workforce. You'll contribute across the full product design lifecycle, from early concepts and user flows to polished interfaces...
...to Team Lead, Clinical Quality and Record Review. Works independently and with other... ...applicable, to obtain information and/or medical records needed to conduct a comprehensive... ...cases and final determinations. Conduct chart reviews and audits both electronic and at...