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Certified Risk Adjustment Coder

Certified Risk Adjustment Coder

Genesis10Eden Prairie, MN, US
3 hours ago
Job type
  • Permanent
  • Temporary
Job description

Genesis10 is currently seeking a Certified Risk Adjustment Coder for a 3-month contract role with our client in the healthcare industry in Eden Prairie, MN. This role is 100% remote.

Description :

The Expert Risk Adjustment Temporary Coder is responsible for performing high-quality, accurate audits of inpatient and outpatient medical records aligned with HCC risk adjustment models (e.g., CMS-HCC, HHS-HCC). This includes retrospective reviews of ICD-10-CM diagnosis coding to validate HCC submissions for risk adjustment purposes.

The role ensures compliance with CMS guidelines, HCC model logic, ACA requirements, and internal quality standards. The coder supports coding accuracy, data integrity, and documentation practices to optimize Medicare Advantage revenue while minimizing compliance risk. The ideal candidate is a subject matter expert in risk adjustment coding, capable of working independently under tight deadlines with minimal supervision.

Key Responsibilities :

  • Abstract and assign ICD-10-CM diagnosis codes and CPT from medical records to capture risk-adjustable conditions.
  • Review EMRs and supplemental data to identify undocumented or misrepresented HCCs.
  • Apply CMS, HHS-HCC guidelines, AHA Coding Clinic guidance, and internal policies.
  • Validate previously coded charts and provide feedback on errors or opportunities for correction.
  • Collaborate with risk adjustment coding managers and project managers to resolve documentation discrepancies.
  • Maintain productivity and accuracy standards as defined by the organization.
  • Protect patient privacy and confidentiality in accordance with HIPAA.
  • Participate in weekly meetings with the client and provide detailed review feedback.
  • Support data collection for RADV audits, suspect condition reviews, or provider education initiatives.

Required Skills :

  • Active coding certification : CCS, CPC, CRC, RHIT, or RHIA.
  • Minimum 3 years of recent risk adjustment coding experience, including retrospective and / or prospective projects.
  • Expert knowledge of ICD-10-CM, CPT, and CMS / HHS HCC models.
  • Familiarity with EMR systems and coding platforms (e.g., EPIC, 3M, Optum Encoder, Inovalon, Cotiviti, Apixio).
  • Expert in Microsoft Excel and documentation tools.
  • Strong understanding of medical terminology, anatomy, physiology, and pathophysiology.
  • Experience with Medicare Advantage and ACA coding.
  • Previous RADV audit support or second-level coding review experience.
  • Experience with NLP-assisted coding tools or risk adjustment analytics platforms.
  • Compensation :

    Hourly W2 pay : $60.00 to $65.00 / hour

    We offer additional contract, contract-to-hire, and direct hire positions with various rates.

    If qualified and interested, apply today!

    Genesis10, ranked a Top Staffing Firm in the U.S., provides access to many Fortune 100 firms and mid-market organizations across various industry verticals.

    Benefits of Working with Genesis10 :

  • Access to hundreds of clients, many with long-standing relationships.
  • Opportunity for a career-home within Genesis10.
  • Experienced recruiting team.
  • Medical, Dental, Vision insurance.
  • Health Savings Account, Voluntary Hospital Indemnity, Voluntary Term Life Insurance.
  • 401K, Sick Pay (where applicable), and Commuter Benefits.
  • Remote opportunities available.
  • Genesis10 is an Equal Opportunity Employer. Candidates will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

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    Certified Coder • Eden Prairie, MN, US

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