Value-Based Risk Adjustment Coder

We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs. This role is 100% remote and ideal for coders who are confident working independently, detail-oriented, and committed to quality and compliance. As a contractor, you’ll have the independence to manage your own schedule while contributing to meaningful work that truly makes a difference.

As part of the coding team, you will review clinical documentation from in-home visits and assign complete and compliant ICD-10-CM diagnosis codes that reflect the full spectrum of each patient’s health.

This includes:

Risk adjustment (HCC) diagnoses aligned with CMS-HCC and HHS-HCC models.

Social Determinants of Health (SDOH) codes.

Medication-related Z codes, such as long-term drug therapy and treatment monitoring.

All other clinically relevant diagnoses supported by documentation.

Your accuracy directly supports the integrity of patient data, ensures proper risk adjustment, and contributes to value-based care performance outcomes. This contract is paid on a per-chart reviewed basis, allowing coders to work at their own pace while maintaining accuracy and productivity expectations.

Key Responsibilities:

Review provider documentation from in-home health assessments and assign all appropriate ICD-10-CM diagnosis codes.

Apply risk adjustment principles to ensure accurate condition capture and model alignment.

Identify and code SDOH and medication-related Z codes when documented.

Verify that all coded diagnoses are fully supported per MEAT/TAMPER standards.

Collaborate with clinical reviewers when clarification or validation is required.

Maintain productivity and accuracy benchmarks in accordance with project standards.

Minimum Qualifications:

3 or more years of experience in outpatient and/or risk adjustment coding (Medicare Advantage, ACA, or Medicaid).

Active CRC, CPC, or equivalent AAPC/AHIMA certification required.

Demonstrated proficiency with ICD-10-CM coding guidelines and risk adjustment methodologies.

Prior experience with in-home assessment documentation strongly preferred.

Working knowledge of SDOH and value-based documentation requirements.

Must be dependable, self-directed, and capable of maintaining accuracy while meeting daily volume expectations.

Preferred Experience:

Experience with encounter data validation, EDPS submissions, or vendor quality audits.

Familiarity with EHR/EMR systems used in home assessment documentation.

Previous exposure to Medicare Advantage or PACE model populations.

Additional Requirements:

All candidates will need to complete a standard background check and a brief coding proficiency assessment as part of the onboarding process. The assessment simply helps confirm familiarity with ICD-10-CM guidelines, HCC concepts, and basic SDOH coding. A passing score ensures the project is a good fit and helps us place coders where they’ll be most successful.

About the Opportunity:

The role offers flexibility, professional autonomy, and the opportunity to contribute to work that meaningfully impacts patient outcomes. You’ll be part of a team dedicated to improving the accuracy of diagnostic coding in in-home assessments, ensuring every patient’s health status is fully and properly represented.

Contractor