Job Summary

Progressive Technology is seeking a highly skilled and certified HCC Medical Coder specializing in Risk Adjustment for the US Healthcare sector. As part of our dynamic team, you will play a pivotal role in ensuring accurate and compliant coding for risk adjustment purposes, contributing directly to the organizations financial and clinical outcomes. This is an exciting opportunity to work with a forward-thinking company that values precision, expertise, and continual improvement in the healthcare coding landscape.

Key Responsibilities

• Perform coding for risk adjustment, ensuring that all diagnoses are accurately assigned in accordance with CMS guidelines and ICD-10-CM coding standards.

• Analyze medical records to identify and accurately code chronic conditions, diseases, and health status indicators that influence reimbursement and care coordination.

• Ensure the accurate and timely submission of coded data for healthcare organizations and insurance providers.

• Work closely with healthcare providers, medical directors, and clinical staff to resolve any coding discrepancies and ensure proper documentation.

• Maintain knowledge of current industry coding standards, regulations, and compliance requirements.

• Participate in quality improvement initiatives, audits, and training to continuously improve coding practices and outcomes.

• Review and update codes as necessary based on changes in medical records or diagnoses to ensure accurate reporting for risk adjustment purposes.

• Provide coding expertise and support to colleagues, as needed, for complex coding issues.

Required Skills and Qualifications

• Certification: Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) with specialized risk adjustment coding experience.

• Experience: Minimum of 2-3 years of experience in HCC coding within the US healthcare system, with a strong understanding of CMS regulations and risk adjustment models (e.g., HCC, Hierarchical Condition Category).

• Technical Skills: Proficiency in ICD-10-CM, CPT, and HCPCS coding systems. Experience with coding software and Electronic Health Record (EHR) systems.

• Knowledge of Healthcare Terminology: In-depth understanding of medical terminology, clinical documentation, and risk adjustment factors.

• Attention to Detail: High level of accuracy and attention to detail in reviewing medical records and applying codes.

• Communication Skills: Strong verbal and written communication skills for collaborating with providers, healthcare teams, and other stakeholders.

• Compliance Knowledge: Thorough understanding of HIPAA regulations, ICD-10-CM coding guidelines, and other healthcare compliance requirements.

Experience

• Minimum of 2-3 years of experience in HCC Medical Coding, Risk Adjustment, or related fields within the US healthcare system.

• Experience with coding audits, chart reviews, and risk adjustment data collection.

• Proven track record of working with various risk adjustment models and their applications.

Working Hours

• Full-time position with flexible working hours.

• Ability to work remotely with occasional in-office meetings, if required.

• Standard working hours are 9 AM - 6 PM EST, with the possibility of overtime based on project needs.

Knowledge, Skills, and Abilities

• Coding Expertise: Mastery of ICD-10-CM coding, risk adjustment models, and healthcare documentation guidelines.

• Analytical Skills: Ability to analyze clinical data and identify appropriate diagnoses for accurate coding.

• Problem-Solving: Ability to identify coding discrepancies and propose solutions effectively.

• Time Management: Strong organizational skills and the ability to prioritize and manage multiple tasks within tight deadlines.

• Collaboration: Team-oriented with the ability to work cross-functionally with healthcare professionals and departments.

• Technology Proficiency: Skilled in using healthcare software, including coding platforms and EHR systems.

Benefits

• Competitive salary based on experience and qualifications.

• Health, dental, and vision insurance.

• Retirement savings plan with employer contributions.

• Generous paid time off (PTO) and holidays.

• Professional development opportunities, including access to coding resources and certifications.

• Flexible work environment with remote work options.

• Employee wellness programs and support.

Why Join Progressive Technology?

At Progressive Technology, we are committed to providing cutting-edge solutions in the healthcare sector. By joining our team, you will work alongside experts in the field, leveraging advanced tools and technologies to improve healthcare outcomes. Our culture is built on innovation, respect, and continuous learning. We offer a collaborative and supportive environment where your skills and contributions are valued. If you are looking for a rewarding opportunity to advance your career while making a significant impact on the healthcare industry, this is the place for you.

How to Apply

Interested candidates are invited to submit their resume and a cover letter outlining their experience and qualifications for the position. Please send your application to us with the subject line HCC Medical Coder - Risk Adjustment Application.

We look forward to reviewing your application and welcoming you to our team!