Value-Based Risk Adjustment Coder (Remote, 1099 Contractor)

We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs. This role is 100% remote and ideal for coders who are confident working independently, detail-oriented, and committed to quality and compliance. As a contractor, you’ll have the independence to manage your own schedule while contributing to meaningful work that truly makes a difference.

As part of the coding team, you will review clinical documentation from in-home visits and assign complete and compliant ICD-10-CM diagnosis codes that reflect the full spectrum of each patient’s health. This includes:

• Risk adjustment (HCC) diagnoses aligned with CMS-HCC and HHS-HCC models.
• Social Determinants of Health (SDOH) codes.
• Medication-related Z codes, such as long-term drug therapy and treatment monitoring.
• All other clinically relevant diagnoses supported by documentation.

Your accuracy directly supports the integrity of patient data, ensures proper risk adjustment, and contributes to value-based care performance outcomes. This contract is paid on a per-chart reviewed basis, allowing coders to work at their own pace while maintaining accuracy and productivity expectations.

Key Responsibilities:

• Review provider documentation from in-home health assessments and assign all appropriate ICD-10-CM diagnosis codes.
• Apply risk adjustment principles to ensure accurate condition capture and model alignment.
• Identify and code SDOH and medication-related Z codes when documented.
• Verify that all coded diagnoses are fully supported per MEAT/TAMPER standards.
• Collaborate with clinical reviewers when clarification or validation is required.
• Maintain productivity and accuracy benchmarks in accordance with project standards.

Minimum Qualifications:

• 3 or more years of experience in outpatient and/or risk adjustment coding (Medicare Advantage, ACA, or Medicaid).
• Active CRC, CPC, or equivalent AAPC/AHIMA certification required.
• Demonstrated proficiency with ICD-10-CM coding guidelines and risk adjustment methodologies.
• Prior experience with in-home assessment documentation strongly preferred.
• Working knowledge of SDOH and value-based documentation requirements.
• Must be dependable, self-directed, and capable of maintaining accuracy while meeting daily volume expectations.

Preferred Experience:

• Experience with encounter data validation, EDPS submissions, or vendor quality audits.
• Familiarity with EHR/EMR systems used in home assessment documentation.
• Previous exposure to Medicare Advantage or PACE model populations.

Additional Requirements:

All candidates will need to complete a standard background check and a brief coding proficiency assessment as part of the onboarding process. The assessment simply helps confirm familiarity with ICD-10-CM guidelines, HCC concepts, and basic SDOH coding. A passing score ensures the project is a good fit and helps us place coders where they’ll be most successful.

About the Opportunity:

The role offers flexibility, professional autonomy, and the opportunity to contribute to work that meaningfully impacts patient outcomes. You’ll be part of a team dedicated to improving the accuracy of diagnostic coding in in-home assessments, ensuring every patient’s health status is fully and properly represented.