job description
Shearwater Health is expanding its remote medical coding team and invites skilled Risk Adjustment Medical Coders to join our mission of improving healthcare accuracy and efficiency. This is a 100% remote role based in Bali, offering a competitive salary, flexible work arrangements, and comprehensive benefits.
As a Risk Adjustment Medical Coder, you will play a critical role in ensuring accurate ICD-10-CM, CPT, and HCC coding to support risk adjustment models, compliance, and revenue integrity. Your expertise will directly impact patient care quality and financial performance for healthcare providers.
If you are a detail-oriented professional with a passion for medical coding and a desire to work in a dynamic, remote-first environment, we want to hear from you. Bali’s vibrant expat community and work-life balance make this an exceptional opportunity for local and international talent.
Responsibility
- Accurately assign ICD-10-CM, CPT, and HCC codes to patient records in compliance with risk adjustment guidelines.
- Review and analyze medical documentation to ensure code specificity, completeness, and accuracy for risk adjustment reporting.
- Collaborate with healthcare providers to clarify diagnoses, procedures, and treatment plans for precise coding.
- Conduct audits and quality checks to identify and correct coding errors, ensuring compliance with CMS and other regulatory standards.
- Stay updated on coding guidelines, industry changes, and risk adjustment methodologies (e.g., CMS-HCC, CDPS).
- Maintain productivity and accuracy metrics, meeting or exceeding performance benchmarks.
- Utilize EHR/EMR systems and coding software (e.g., Epic, 3M, Optum) to streamline workflows.
- Participate in team meetings, training, and continuous education to enhance coding expertise.
Qualifications
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or CRC (Certified Risk Adjustment Coder) credential required.
- Minimum 2+ years of experience in risk adjustment coding (HCC, CDPS, or similar models).
- Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding with a focus on chronic conditions and hierarchical condition categories (HCCs).
- Strong understanding of medical terminology, anatomy, and pathophysiology.
- Experience with EHR/EMR systems (e.g., Epic, Cerner) and coding software (e.g., 3M, Optum Encoder).
- Excellent attention to detail, analytical skills, and ability to interpret complex medical records.
- Self-motivated with time management skills to meet deadlines in a remote setting.
- Familiarity with CMS guidelines, AAPC/AHIMA standards, and risk adjustment audits is a plus.