Risk Management Jobs 2026 (Now Hiring) – Smart Auto Apply

Position Purpose: Codes, abstracts and analyzes inpatient and/or outpatient medical records using the most current International Classification of Diseases, Ninth Revision (ICD-9) for CMS risk adjustment purposes. Education/Experience: Required A High School or GED Preferred A Bachelor's Degree in a related field Candidate Experience: Required 2+ years of experience in professional coding experience either in a hospital or physician setting Preferred Other Healthcare industry experience Licenses and Certifications: A license in one of the following is required: Required Certified Professional Coder (CPC) Preferred Certified Coding Specialist (CCS) Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9). Always coding to the highest level of specificity. Follows the Official ICD-9 guidelines for Coding and Reporting and has a complete understanding of these guidelines. Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines. Understands the impact of ICD-9 codes on the CMS HCC risk adjustment model. Ability to meet productivity and accuracy standards Ability to defend coding decisions to both internal and external audits. Performs other duties as assigned. Performs other duties as assigned Complies with all policies and standards EEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans. ============

Story Behind the Need
What is the purpose of this team? Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs or is this request part of a larger hiring initiative?	Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10) for CMS risk adjustment purposes. Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10). Always coding to the highest level of specificity. Code in multiple lines of business such as Marketplace (ACA) and Medicare Advantage Follows the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines. Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines. Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model. Ability to meet productivity and accuracy standards Ability to defend coding decisions to both internal and external audits. Performs other duties as assigned. Work environment is positive and engaging.
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are the performance expectations/metrics? What makes this role unique?	Coders will work daily reviewing medical records abstracting HCCs for members. Coders will also work on additional special projects as needed dependent on business needs. 100% Remote Accuracy: 95% Production: 7-9 HCC s an hour
Candidate Requirements: Reiterating note from req 155201- In speaking with a few candidates to gain a clear picture that rely on AI or what they refer to as asynchronous coding here is some feedback I have to share. Some candidates shared they are presented with a blurb with a diagnosis code pre-selected by the provider. In the event they need to make a change to a diagnosis code they do not review the entire date of service/record to validate the ICD10 code. They truly rely only on submitting a query to the physician for further clarification and make their diagnosis code selection based on the provider's response only. Overall, they do not review the record to confirm the diagnosis or if there is conflicting docuemntation within the record, indicating they are not truly abstracting diagnosis codes which does not align with their resume. Other candidates rely on different forms of AI coding where they are only searching for the diagnosis, or they are presented with a pre-selected diagnosis code. Again, they do not review the entire date of service/record and are only confirming if the diagnosis code is presented on one page versus the record. This also does not align with their resume as it is not abstracting diagnosis codes. What I am encountering with these candidates in the interview is they express difficulty or have inconsistencies of walking me through the basics when reviewing medical records or medical coding basics as they are accustomed in working in an AI coding enviornment. I do acknowledge they are conforming to their employers work enviornment, systems, and protocols, but they have difficulty in the basics of medical coding. I am unable to onboard candidates with these challenges as we are looking for candidates that have the true knowledge/background to ensure they will be able to absorb training while working in a fast-paced working environment. I also need to ensure a smooth onboarding process in setting up the candidate for success. I am disqualifying resumes with any mention of AI or asynchronous coding but there are few. I am finding their resumes do not indicate this as their background as it appears they use verbiage such as abstracting diagnosis codes and they have expereince in what we are looking for to fill these roles. Other resumes have a strong background in claims/billing which is not the same as medical coding. I am working on mitigating and identifying these candidates as it doesn t meet the requirements we are seeking to fill this role. Overall, we truly need medical coders with the capability of paying close attention to detail with the documentation that is presented within a record in our system and have the ability to abstract diagnosis codes from scratch. They should be able to accomplish this by indexing the diagnosis code from their ICD-10 code book as we do not fully rely on encoders nor do we rely on AI technology regard diagnosis codes. We rely on the medical coder to complete this task to ensure accuracy on the quality of work completed. I hope this detailed explanation paints a clear picture of my concerns and the challenges I am facing during this process. If you need additional information, please let me know and I will be happy to provide further information. Thank you, "