Remote Risk Adjustment Coder Jobs in Claymont, DE

Coder II
Location: Remote
Organization: Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder

Overview

Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Coder to join our team remotely. As two of the region’s most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development.

Position Summary

This role is responsible for accurately reviewing medical records and assigning ICD-10 and CPT codes in compliance with all applicable policies and regulations. It manages patient demographics, clinical documentation, and billing data across practice management systems and hospital records to ensure proper coding and reimbursement. The position also supports and educates clinical staff and providers on documentation and coding standards to promote compliance, accuracy, and effective communication. This is a full time remote Monday-Friday position. 

Key Responsibilities 

• Abstracts data in compliance with national, regional, and local policies, and interprets and reviews medical record documentation to assign accurate ICD-10 diagnosis and CPT procedure codes.
• Utilizes practice management system (PMS) to accurately account for demographics and services performed for all scheduled and unscheduled surgical cases according to standard procedures and coding guidelines.
• Utilizes individual hospital medical record systems and coordinates with physicians and staff to obtain clinical documents and demographics required for appropriate coding and billing for all hospital procedures.
• Provides education and support to clinical areas regarding appropriate documentation and coding of services to achieve accurate billing. Maintains effective communication with providers concerning coding issues. 

Qualifications

Education:

• High school diploma/GED or equivalent working knowledge preferred.

Licenses & Certifications

• Accredited by the American Health Information Management Association (CCS-P) or the American Academy of Professional Coders (CPC). 

Experience:

• Ideal candidates should have 3-5 years of professional medical coding experience, preferably in a multi-specialty environment with experience in orthopedics, surgery, pain management, spine, or other complex procedural coding.
• Candidates should have demonstrated experience reviewing operative reports and clinical documentation, assigning accurate CPT, ICD-10-CM, HCPCS, and modifiers, and resolving coding edits or documentation discrepancies.
• Experience with coding audits, payer guidelines, NCCI edits, and physician queries is strongly preferred. A current professional coding certification such as CPC, CCS, COC, or equivalent is preferred/required based on organizational standards.

Skills: Candidates should demonstrate strong knowledge of CPT, ICD-10-CM, HCPCS Level II, modifiers, NCCI edits, global surgical guidelines, and payer-specific coding requirements. They should be proficient in interpreting complex operative reports and determining appropriate code selection based on the documented procedure rather than relying solely on procedure titles. Strong research, analytical, and problem-solving skills are essential, along with attention to detail and a commitment to coding accuracy and compliance. Candidates should also possess effective written and verbal communication skills, including the ability to clearly communicate coding concerns, request documentation clarification, and collaborate professionally with providers, Coding leadership, Authorization, Revenue Cycle, and other operational teams.

Abilities: Successful Coder II candidates should be able to work independently with limited supervision, manage a consistent coding workload while meeting productivity and accuracy expectations, and appropriately escalate complex or uncertain cases. They should be able to recognize documentation deficiencies, identify potential compliance concerns, research unfamiliar procedures, apply coding guidelines consistently, and adapt to multiple specialties and changing payer requirements. Candidates should demonstrate sound judgment, accountability, organization, critical thinking, and the ability to prioritize competing demands while maintaining quality and timely turnaround.

Compensation & Benefits  

• Comprehensive benefits package including medical, dental, and vision plans
• 100% employer-paid life insurance
• 401(k) with employer match
• Benefits begin the first of the month following hire date (for full-time employees)
• Generous paid sick and vacation time
• 7 paid holidays annually
• Opportunities for growth and advancement
• Employee referral reward program

About Premier Orthopaedics & Philadelphia Hand to Shoulder

Premier Orthopaedics and Philadelphia Hand to Shoulder Center (PHSC) are leading providers of comprehensive musculoskeletal care throughout Pennsylvania, New Jersey, and Delaware.

Premier Orthopaedics delivers expert treatment for orthopedic injuries, joint disease, interventional spine care, regenerative medicine, and comprehensive physical therapy services, supported by more than 150 providers across 50+ locations. Our facilities include state-of-the-art MRI centers, outpatient surgery centers, physical therapy clinics, and orthopedic urgent care centers to ensure timely access to high-quality, patient-focused care.

Philadelphia Hand to Shoulder Center (PHSC), a division of Premier Orthopaedics, has been nationally recognized for more than 50 years for its specialized care of the hand, wrist, elbow, arm, and shoulder. Our fellowship-trained surgeons and certified Hand and Occupational Therapists collaborate to provide seamless care—from diagnosis and treatment to post-operative and rehabilitative recovery. With 14 convenient locations across Pennsylvania and New Jersey, PHSC offers advanced, integrated care to restore function, mobility, and quality of life for patients with upper extremity conditions.