Risk Adjustment Coding Specialist - Remote
Description:
**Employment Type:**
Full time
**Shift:**
**Description:**
The HCC Risk Coder is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.
**Position Purpose:**
+ Risk Adjustment Coding Specialist works in a team environment and is responsible for ensuring accurate ICD-9/10 documentation and capturing the HCC diagnostics code for the patient billing process.The **HCC Risk Coder** is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.
+ Specialty: Medical Group
+ Location: Remote
+ Hours of office: Monday – Friday: 5:30a – 4:30p or 6:00p
**What You Will Do:**
+ Reviews patient record prior to appointment to determine Gaps in Care, then communicates Gaps to provider.
+ Recognizes opportunities for documentation improvement and educates providers and staff of suggested improvements.
+ Collaborates with providers to formulate appropriate modifications to clinical documentation to reflect the appropriate use of clinical codes and documentation
**Minimum Qualifications:**
+ Education: High school graduate or GED required
+ Licensure / Certification:
+ CPC required
+ Certified Risk Adjustment Coder certification within one year of hire required.
+ Experience: Minimum of two years of experience in medical coding and billing required
**Position Highlights and Benefits:**
+ Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
+ Retirement savings account with employer match starting on day one.
+ Generous paid time off programs.
+ Employee recognition programs.
+ Tuition/professional development reimbursement.
+ Relocation assistance (geographic and position restrictions apply).
+ Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.
+ Employee Referral Rewards program.
+ Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!
+ Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
**Ministry/Facility Information:**
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
**Our Commitment**
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran