HCC Risk Adjustment Coder

Job not on LinkedIn

🕒 Yesterday

⛰️ Colorado – Remote

⛰️ Colorado – Remote

⏱ Part Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Pinnacle Healthcare Consulting

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1998

🏥 Healthcare

📦 Logistics

⚖️ Legal

Healthcare • Logistics • Legal

Pinnacle Healthcare Consulting is a nationally recognized healthcare consulting firm that provides strategic, financial, operational, compliance, and valuation services to healthcare organizations. The firm offers services including compensation and fair market value opinions, business valuation and transaction support, value-based care strategy, coding and compliance, revenue cycle management, real estate consulting, and life sciences transaction advisory. Pinnacle serves hospitals, health systems, physician practices, ambulatory surgery centers, digital health companies, dialysis and kidney care companies, law firms, private equity, and nonprofit organizations, delivering practical, data-driven solutions to manage risk, improve performance, and support transactional and regulatory needs.

📋 Description

• 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

• 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

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