HCC Risk Adjustment Coder

Pinnacle Healthcare Consulting

. Review medical records via PDF or electronic medical record system .

Posted 9/15/2026part-timeRemote • Colorado • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical coding, including ICD-10, CPT, and HCPCS, with a strong focus on Medicare Risk Adjustment and compliance with coding guidelines. Proven ability to maintain high accuracy rates while managing multiple projects in a fast-paced environment.

Highest-signal resume keywords

Certified Coder Certification (CRC, CPC, CPMA, CCS-P)ICD-10 Coding ProficiencyMedicare Risk Adjustment ExperienceMedical Record AnalysisAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CPT CodingHCPCS CodingICD-10 CodingCoding Compliance AnalysisData ValidationMedical Record DocumentationRisk Adjustment CodingE/M CodingMedical TerminologyChronic Illness Management

Soft Skills

Strong Organization SkillsInterpersonal SkillsCustomer Service SkillsAnalytical SkillsWritten and Oral Communication Skills

Tools & Technologies

MS OfficeMS WindowsInternetElectronic Medical Record SystemData Portals

Certifications & Qualifications

CPCCPMACRCRHITCCS

Industry Keywords

HIPAA ComplianceMedical Coding GuidelinesHealthcare OperationsMedicare GuidelinesMedicaid Guidelines

About the role

Key responsibilities & impact

Review medical records via PDF or electronic medical record system
Abstract and assign CPT/HCPCS, ICD, and modifier codes
Research and resolve assigned coding projects
Document requested information from medical records
Determine valid encounters, including legibility and valid signature requirements
Identify valid face-to-face encounters
Analyze medical record charts for coding compliance
Validate coding against payor guidelines and client coding protocols
Meet daily production goals and maintain an average 95% accuracy rate consistently
Attend conference calls as necessary to provide information and feedback

Requirements

What you’ll need

Active certified coder certification (CRC, CPC, CPMA, CCS - P) through AHIMA or AAPC
Holding at least one active AAPC or AHIMA certified program with the achievement of the correlating professional credential (RHIT, CPC, CCS, CPC-H etc.); in active and in good standing with the certifying organization
High School diploma required
Minimum of three (3) years of coding experience (recent hands-on production) in both areas
At least one (1) year of specialized experience in Medicare Risk Adjustment
Minimum four (4) years of experience as a certified coder/auditor in multi-specialties
Minimum two (2) years of risk adjustment and provider evaluation and management (E/M) experience
Ability to code ICD-10, modifier and CPT/HCPCS
Computer proficiency including MS Windows, MS Office, and the Internet
High-speed Internet access
Knowledge of HIPAA, privacy, security, and confidentiality requirements
Strong clinical knowledge related to chronic illness management, evaluation, assessment and treatment (MEAT)
Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines
Knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements highly preferred
Reliability and commitment to meeting tight deadlines
Personal discipline to work remotely without direct supervision
Exemplary attention to detail and completeness
Strong organization, interpersonal, and customer service skills
Written and oral communication skills
Analytical skills
Thorough knowledge of medical anatomy and terminology
Understanding of medical and business aspects of healthcare operations
Ability to read and understand Medicare, Medicaid, and third-party payer guidelines
Ability to multitask in a fast-paced environment
Strong computer skills including MS Office, Excel, Word, Internet, and email
Ability to navigate internal network and external internet data portals
Strong organization skills and ability to work autonomously
Ability to effectively communicate with multi-level personnel, medical professionals, clients, public, and other business representatives
Excellent verbal and written communication skills
Ability to learn quickly
Ability to successfully work on multiple projects/accounts simultaneously with frequent interruptions
CPC, CPMA, and CRC credentials preferred
College degree preferred

Benefits

Comp & perks

100% REMOTE - Work from home
Flexible working schedule
Paid training