Certified Risk Adjustment Coder

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 both inpatient and outpatient medical records in alignment with HCC risk adjustment models (e.g., CMS-HCC, HHS-HCC). This includes conducting retrospective reviews of ICD-10-CM diagnosis coding to validate the accuracy of 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 appropriate 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 appropriate ICD-10-CM diagnosis codes and CPT from medical record documentation to capture risk-adjustable conditions

* Review EMRs (electronic medical records) and supplemental data to identify undocumented or misrepresented HCCs

* Apply CMS and HHS-HCC risk adjustment coding guidelines, AHA Coding Clinic guidance, and internal policies

* Perform validations of previously coded charts and provide feedback on opportunities or errors, under and over changing.

* Collaborate with risk adjustment coding managers and project managers to identify and resolve documentation discrepancies

* Maintain productivity and accuracy standards as defined by the project and/or organization

* Protect patient privacy and confidentiality in accordance with HIPAA

* Participate in ongoing weekly meetings with client and provide detailed feedback in regards to ongoing review.

* 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-level knowledge of ICD-10-CM, CPT and CMS HCC and/or HHS HCC models * Familiarity with EMR systems and coding platforms (e.g., EPIC, 3M, Optum Encoder, Inovalon, Cotiviti, Apixio, etc.)

* Expert in Microsoft Excel and common documentation tools

* Strong understanding of medical terminology, anatomy & physiology, and pathophysiology

* Experience with both Medicare Advantage and ACA coding

* Previous RADV audit support or involvement in second-level coding review

* Experience with NLP-assisted coding tools or risk adjustment analytics platforms

Compensation:

Hourly W2 pay: $60.00 to $65.00/hour

We have access to additional contract, contract-to-hire, and direct hire positions with various rate ranges.

If you have the qualifications described and are interested in this exciting opportunity, apply today!

Ranked a Top Staffing Firm in the U.S. by Staffing Industry Analysts for six consecutive years, Genesis10 puts thousands of consultants and employees to work across the United States every year-in contract, contract-for-hire, and permanent placement roles. With more than 300 active clients, Genesis10 provides access to many of the Fortune 100 firms and a variety of mid-market organizations across the full spectrum of industry verticals.

Benefits of Working with Genesis10:

• Access to hundreds of clients, most who have been working with Genesis10 for 5-20+ years.
• The opportunity to have a career-home in Genesis10; many of our consultants have been working exclusively with Genesis10 for years.
• Access to an experienced, caring recruiting team (more than 7 years of experience, on average.)
• Medical, Dental, Vision
• Health Savings Account
• Voluntary Hospital Indemnity (Critical Illness & Accident)
• Voluntary Term Life Insurance
• 401K
• Sick Pay (for applicable states/municipalities)
• Commuter Benefits (Dallas, NYC, SF, and Illinois)
• Remote opportunities available

For multiple years running, Genesis10 has been recognized as a Top Staffing Firm in the U.S., as a Best Company for Work-Life Balance, as a Best Company for Career Growth, for Diversity, and for Leadership, amongst others. To learn more and to view all our available career opportunities, please visit us at our website.

Genesis10 is an Equal Opportunity Employer. Candidates will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.