Certified Clinical Quality Coder

To support clinical integration efforts, the full-time Certified Clinical Quality Coder will conduct reviews of outpatient medical records using ICD-10-CM and CPT coding, ensuring accurate assignment of diagnoses and procedures while working remotely. Key responsibilities: Conduct medical record reviews to ensure accurate coding and reporting of diagnoses and procedures Perform pre-appointment reviews of encounters to identify potential clinical conditions for physician alert Support risk adjustment code validation for CMS and HHS Risk Adjustment models Required qualifications: High School Diploma or General Education Diploma (GED) Certification as a CRC, CPC, or other relevant coding certification One year of recent experience with CMS-HCC and HHS-HCC risk adjustment coding Advanced knowledge of ICD-10 coding conventions and Medicare Advantage coding requirements Proficient in using coding software and reference materials for diagnosis code assignment