Medical Coder - 252026

Risk Adjustment Medical CoderLocation:Remote***MUST LIVE IN THE STATE OF NEW YORK, NEW JERSEY OR CT*** Schedule:Monday–Friday, 9:00 AM – 5:00 PMPosition Overview Join a growing Risk Adjustment team at a pivotal time of expansion. We are seeking an experiencedRisk Adjustment Coder & Auditorto support coding integrity, audit readiness, and CMS compliance in a highly specialized, high-impact role. This is an opportunity to be part of asmall, high-performing teamwhere your work will directly influence quality, compliance, and outcomes across a complex patient population.What You’ll Do Perform detailedmedical record reviews and HCC code abstractionusing ICD-10-CM guidelines Ensure accuracy and completeness of coding aligned withCMS Risk Adjustment models SupportRADV audit readiness(occurring quarterly), validating documentation for compliance (MEAT criteria, signatures, dates, etc.) Evaluate coding from ahealth plan perspective , ensuring appropriate capture of patient complexity Identifydocumentation gapsand partner with leadership to provide provider education Maintain95%+ accuracywhile meeting productivity expectations Contribute to a culture ofquality, compliance, and continuous improvementRequired Qualifications 3+ years of recent HCC / Risk Adjustment coding experience Experience within aHealth Plan or auditing environmentstrongly preferred Dual certification required : CPC, CCS, RHIT, or RHIAAND CRC (Certified Risk Adjustment Coder) Strong knowledge of: ICD-10-CM Clinical terminology, anatomy, physiology, pharmacology Experience validating documentation againstCMS guidelines and MEAT criteria Proven ability to maintainhigh audit accuracy (95%+) Must reside inNY, NJ, or CTPreferred Background 8+ years of Risk Adjustment experience DirectRADV audit exposure Experience working for aHealth Plan or Managed Care Organization Inpatient coding or auditing experience Strong analytical skills with ability to identify trends and support provider education Familiarity with claims systems andMedicare COB processesWhy This Role Stands Out Direct Hire Stability– Full-time, permanent role (not contract-based) True Work-Life Balance– Monday–Friday, 9–5. No weekends, no overtime expectations Fully Remote (Tri-State)– Save time and money while staying connected to a respected healthcare organization Foundational Team Opportunity– Be one of the first hires and help shape the function alongside leadership High-Impact Work– Direct exposure toRADV auditsand high-level CMS compliance Strong Benefits Package– PTO + 10 paid holidays, Medical/Dental/Vision, 403(b), and education reimbursement