Certified Risk Adjustment Coder / Auditor (CRC Preferred)
Ideal Tech Staffing is seeking an experienced Certified Risk Adjustment Coder/Auditor with expertise in Hierarchical Condition Category (HCC) coding, medical chart reviews, and clinical documentation improvement. This is a highly specialized role requiring advanced knowledge of risk adjustment methodologies, documentation compliance, and provider education.
The ideal candidate has a strong background in reviewing complete medical records, validating diagnoses using established documentation standards, and supporting providers through auditing and education to ensure accurate risk adjustment coding.
Key Responsibilities- Perform comprehensive medical chart reviews to validate diagnosis coding for risk adjustment.
- Conduct Risk Adjustment (HCC) chart reviews to ensure coding accuracy and compliance.
- Review documentation using the MEAT Criteria (Monitor, Evaluate, Assess/Address, and Treat) to validate reportable diagnoses.
- Identify documentation gaps and provide recommendations through Clinical Documentation Improvement (CDI) initiatives.
- Perform coding audits and ensure diagnoses are fully supported for Risk Adjustment Data Validation (RADV) compliance.
- Educate and train providers, coders, and auditors on risk adjustment coding guidelines, documentation requirements, and best practices.
- Ensure chronic conditions are accurately documented and captured annually in accordance with risk adjustment requirements.
- Collaborate with clinical and operational teams to improve coding quality and documentation accuracy.
Qualifications
Required- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification.
- Certified Risk Adjustment Coder (CRC) certification from AAPC strongly preferred, or equivalent risk adjustment credential.
- Proven experience in:
- Risk Adjustment (HCC) Coding
- Medical Chart Reviews
- Coding Audits
- Clinical Documentation Improvement (CDI)
- Strong understanding of:
- HCC Risk Adjustment methodologies
- MEAT documentation criteria
- Annual recapture requirements
- Co-existing condition coding
- RADV audit standards
- Excellent analytical, auditing, and communication skills.
- Experience providing training or education to providers, coders, or auditors.
- Familiarity with Medicare Advantage risk adjustment programs.
- Experience working with electronic health records (EHRs).
Why Join Ideal Tech Staffing?
At Ideal Tech Staffing, you'll have the opportunity to work with a team dedicated to quality, compliance, and excellence in healthcare support. We're looking for professionals who are passionate about improving documentation accuracy, ensuring coding integrity, and making a meaningful impact in risk adjustment and value-based care.
If you have the specialized expertise we're looking for, we'd love to hear from you. Send your updated resume to ••••@idealtechstaffing.com.