Risk Adjustment Coder

McKesson•Houston, TX

About The Position

Innovent Oncology, LLC is seeking a detail-oriented Risk Adjustment Coder to ensure accurate and complete coding for diagnoses and services to support risk adjustment programs. This role is crucial for optimizing our healthcare revenue cycle and maintaining compliance with regulatory guidelines.

Requirements

Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) certification required (AHIMA or AAPC).
Minimum of 2 years of experience in risk adjustment coding, preferably in an oncology or multi-specialty setting.
In-depth knowledge of ICD-10-CM coding guidelines, HCCs, and risk adjustment methodologies.
Strong understanding of medical terminology, anatomy, and physiology.
Proficiency in reviewing and interpreting complex medical records.
Excellent analytical and problem-solving skills with meticulous attention to detail.
Ability to work independently and as part of a team in a fast-paced environment.
Strong written and verbal communication skills.
Proficiency with Microsoft Office Suite (Word, Excel) and various EHR systems.

Responsibilities

Review and abstract medical record documentation (e.g., progress notes, hospital records, lab results) to identify all relevant diagnoses and procedures.
Assign appropriate ICD-10-CM codes and CPT/HCPCS codes based on documentation and official coding guidelines.
Ensure accurate and complete capture of chronic conditions and Hierarchical Condition Categories (HCCs) for risk adjustment purposes.
Identify and query providers for clarification or additional documentation when necessary to support accurate coding.
Stay up-to-date with current coding guidelines, regulations, and industry best practices related to risk adjustment.
Participate in internal and external coding audits and provide feedback for process improvement.
Collaborate with clinical staff and other departments to improve documentation quality and coding accuracy.
Maintain strict confidentiality of patient information and adhere to all HIPAA regulations.
Utilize coding software and electronic health record (EHR) systems proficiently.