Coder 1/HCC Risk Adjustment

Cotiviti•Remote,

3d•$23 - $27•Remote

About The Position

The Coder I is responsible for conducting accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial, and Medicaid risk‑adjustment programs across a variety of chart types. This role applies ICD‑10‑CM Official Guidelines, AHA Coding Clinic guidance, and Cotiviti/client‑specific requirements to ensure high‑quality coding outcomes. The Coder I utilizes established dispute‑resolution processes when coding disagreements arise and communicates professionally with team leadership regarding findings, errors, and improvement opportunities. We are currently looking for multiple Remote Risk Adjustment / HCC Coders (Coder 1) for full-time permanent positions.

Requirements

Minimum High School Diploma.
Nationally certified coder in good standing through AAPC or AHIMA (CRC, CPC, CCS, etc.).
1-2 years’ experience in medical risk adjustment / HCC coding.
Experience in HCC record abstraction and coding requirements.
Demonstrated high level of quality accuracy and productivity in clinical coding work.
Maintains professional credential in good standing as required by AAPC and/or AHIMA.
Adherence to official coding guidelines, coding clinic determinations, CMS, Client specific guidelines and other regulatory compliance guidelines and mandates
Strong knowledge of medical terminology and anatomy and physiology
Intermediate skills and knowledge of computers with the ability to use the designated coding platform for coding processes with focus on both production and accuracy
Skills in organization and time management
Ability to read and understand medical record documentation for diagnosis extraction
Comfortable with computers and technology
Must abide by all HIPAA and associated patient confidentiality requirements
Excellent written and communication skills with the ability to understand and explain complex information.
Ability to regularly and consistently achieve over 95% quality accuracy.
Ability to appropriately communicate with management regarding workload, production expectations and deliverables.
Quick learner with positive attitude.
Must be able to work in a fast-paced environment.
Ability to manage and meet deadlines.
Adaptability to changing priorities, flexible and open to new ideas.
Must participate in all required training.
Must be able to provide a dedicated, secure work area.
Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
Remaining in a stationary position, often standing or sitting for prolonged periods.
Repeating motions that may include the wrists, hands, and/or fingers.

Responsibilities

Reviews medical records for accurate, compliant, and complete diagnosis code abstraction from a variety of chart and encounter types to support Medicare, Commercial and Medicaid prospective, concurrent and retrospective risk adjustment program initiatives
Stays current on coding guidelines necessary for the position by attending all Cotiviti required trainings, workshops, and personal research as appropriate.
Professionally communicates finds, errors, and suggestions to Team Lead to facilitate on-going communications and efficient department operations as part of a continuous improvement process
Complete all responsibilities as outlined in the annual performance review and/or goal setting.
Complete all special projects and other duties as assigned.
Must be able to perform duties with or without reasonable accommodation.