Medical Coding Specialist (HCC / Risk Adjustment) — Remote

Pay Rate: $30.00/hour
Schedule: Monday–Friday, 8:00 AM – 4:30 PM (CST)
Location: Remote 

Position Summary

We are seeking an experienced Medical Coding Specialist with HCC/Risk Adjustment experience to support outpatient provider documentation and accurate condition capture. This role is responsible for reviewing medical records, assigning appropriate ICD-10 and CPT codes, identifying eligible HCC conditions, and supporting accurate problem lists in the EHR. The ideal candidate is detail-oriented, productive, and comfortable working independently in a remote environment while collaborating closely with clinical teams.

Key Responsibilities

• Review outpatient medical records and abstract relevant clinical and demographic data.

• Assign accurate ICD-10 and CPT codes in accordance with current coding guidelines.

• Identify and validate HCC conditions based on provider documentation and risk adjustment guidelines.

• Request clarification or additional documentation from providers when diagnoses are missing or unclear.

• Update problem lists and medical records in the EHR per established workflows.

• Maintain productivity and accuracy standards (minimum 50 charts/day with 90%+ accuracy).

• Communicate quality concerns or documentation issues to appropriate clinical staff.

• Follow all HIPAA and patient privacy regulations.

• Participate in virtual team meetings, training sessions, and ongoing education.

• Attend monthly onsite meetings or special training sessions as required.

Required Qualifications

• High School Diploma or equivalent

• 3–5 years of outpatient medical coding experience

• Minimum 2 years of HCC / Risk Adjustment coding experience

• Strong knowledge of ICD-10 and CPT coding systems

• Active coding certification: CPC, CRC, COC, or CCA (AAPC or AHIMA)

• Experience handling protected health information (PHI)

• Ability to meet productivity and accuracy benchmarks

Preferred Qualifications

• Oncology coding experience

• Experience working in provider-based outpatient settings

• Strong Excel skills

Remote Work Requirements

• Dedicated home workspace suitable for confidential medical work

• Reliable high-speed internet

• Ability to be on camera during meetings and training

• Ability to attend required monthly onsite meetings in The Woodlands, TX (unless out of region)

Skills and Competencies

• Excellent attention to detail and accuracy

• Strong communication and provider query skills

• Critical thinking and problem-solving ability

• Self-motivated and able to work independently

• Strong organization and time management skills

• Adaptable and comfortable with changing guidelines and workflows