Clinical Risk Adjustment Coder

The Clinical Risk Adjustment Coder reviews medical records and provider documentation to identify, validate, and accurately code chronic conditions and diagnoses in accordance with Hierarchical Condition Category (HCC) risk adjustment models. This role plays a key part in ensuring accurate risk score capture, supporting provider education, and maintaining compliance with CMS and payer coding guidelines. The position involves conducting in-home or virtual health assessments, assigning ICD-10-CM codes, and collaborating with clinical staff to improve documentation accuracy.