[Hiring] Coder 1/HCC Risk Adjustment @Cotiviti

Role Description

The Coder I is responsible for conducting accurate, compliant, and complete diagnosis code abstraction for Medicare, Commercial, and Medicaid risk‑adjustment programs across a variety of chart types. This role applies ICD‑10‑CM Official Guidelines, AHA Coding Clinic guidance, and Cotiviti/client‑specific requirements to ensure high‑quality coding outcomes. The Coder I utilizes established dispute‑resolution processes when coding disagreements arise and communicates professionally with team leadership regarding findings, errors, and improvement opportunities.

We are currently looking for multiple Remote Risk Adjustment / HCC Coders (Coder 1) for full-time permanent positions.

Responsibilities:

• Reviews medical records for accurate, compliant, and complete diagnosis code abstraction from a variety of chart and encounter types to support Medicare, Commercial, and Medicaid prospective, concurrent, and retrospective risk adjustment program initiatives.
• Stays current on coding guidelines necessary for the position by attending all Cotiviti required trainings, workshops, and personal research as appropriate.
• Professionally communicates findings, errors, and suggestions to Team Lead to facilitate ongoing communications and efficient department operations as part of a continuous improvement process.
• Completes all responsibilities as outlined in the annual performance review and/or goal setting.
• Completes all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

Qualifications

• Minimum High School Diploma.
• Nationally certified coder in good standing through AAPC or AHIMA (CRC, CPC, CCS, etc.).
• 1-2 years’ experience in medical risk adjustment / HCC coding.
• Experience in HCC record abstraction and coding requirements.
• Demonstrated high level of quality accuracy and productivity in clinical coding work.
• Strong knowledge of medical terminology and anatomy and physiology.
• Intermediate skills and knowledge of computers with the ability to use the designated coding platform for coding processes with focus on both production and accuracy.
• Skills in organization and time management.
• Ability to read and understand medical record documentation for diagnosis extraction.
• Comfortable with computers and technology.
• Must abide by all HIPAA and associated patient confidentiality requirements.

Requirements

• Required hours for training: Monday-Friday 8 AM – 5 PM ET.
• Required working hours: 40 hours per week, Monday-Friday 8-hour days; daytime schedule based on your time zone. This role is not intended to work nights, weekends, or part-time.
• Excellent written and communication skills with the ability to understand and explain complex information.
• Ability to regularly and consistently achieve over 95% quality accuracy.
• Ability to appropriately communicate with management regarding workload, production expectations, and deliverables.
• Quick learner with a positive attitude.
• Must be able to work in a fast-paced environment.
• Ability to manage and meet deadlines.
• Adaptability to changing priorities, flexible and open to new ideas.

Benefits

• Base compensation ranges from $23.00 to $26.50 per hour.
• Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.
• This role is eligible for discretionary bonus consideration.
• Nonexempt employees are eligible to receive overtime pay for hours worked in excess of 40 hours in a given week, or as otherwise required by applicable state law.
• Cotiviti offers a competitive benefits package including medical, dental, vision, disability, and life insurance coverage.
• 401(K) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti.