Certified Risk Adjustment Coder

Job Summary

A company is looking for a Risk Adjustment Coder (RADV).

Key Responsibilities

• Analyze medical records to ensure accurate coding of diagnoses in compliance with ICD-10-CM and risk adjustment guidelines
• Validate submitted diagnosis codes against documentation in patient medical records for CMS-HCC, HHS-HCC, and other applicable models
• Participate in internal and external quality assurance audits, providing feedback and implementing corrective actions as necessary

Required Qualifications

• High school diploma or equivalent (required); Associate's or Bachelor's degree in Health Information Management or related field (preferred)
• Active certification as a Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS)
• Minimum 2-3 years of experience in medical coding with a focus on Hierarchical Condition Category (HCC) risk adjustment and RADV audits
• Proficient understanding of CMS and HHS risk adjustment models
• Familiarity with EHR systems and medical record documentation standards