Certified Clinical Coder

To support clinical integration efforts, the full-time Certified Clinical Coder will conduct outpatient medical record reviews using ICD-10-CM and CPT coding, ensuring accurate assignment of diagnoses and procedures while working remotely.

Key responsibilities

• Review outpatient medical records for accurate coding and compliance with CMS guidelines
• Perform pre-appointment reviews to identify potential clinical conditions for physician follow-up
• Support risk adjustment code validation for CMS and HHS Risk Adjustment models

Required qualifications

• High School Diploma or GED
• Certification as a CRC, CPC, or other relevant coding certification
• One year of experience with CMS-HCC and HHS-HCC risk adjustment coding
• Advanced knowledge of ICD-10 coding conventions and Medicare Advantage requirements
• Proficiency in using coding software and reference materials