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Risk Adjustment Coder

Company

Our Clients

Location

Taguig, Metro Manila

Type

full time

The Risk Adjustment Coder is responsible for reviewing and accurately assigning diagnosis codes to medical records in accordance with ICD-10-CM coding guidelines, CMS-HCC Risk Adjustment methodologies, and client-specific requirements. This role ensures complete and compliant documentation to support accurate risk score capture while maintaining high standards of coding quality, productivity, and regulatory compliance.

Key Responsibilities

  • Review outpatient and physician medical records to identify and assign accurate ICD-10-CM diagnosis codes.
  • Apply CMS-HCC Risk Adjustment coding guidelines and ensure proper Hierarchical Condition Category (HCC) capture.
  • Validate medical documentation to ensure diagnoses are fully supported and compliant with coding standards.
  • Maintain coding accuracy while meeting productivity and quality benchmarks.
  • Stay current with annual ICD-10-CM, CMS-HCC, and regulatory guideline updates.
  • Participa...

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