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Freelance Hcc Risk Adjustment Coder Jobs in Ohio

DaMar Staffing

HIM Coder - Professional

Portsmouth, OH · On-site

$55 - $75/hr

Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.

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Purposelink Recruitment

Remote Nurse Practitioner

OH · Remote

Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background in home‑based care, transitional care, or chronic disease management Overview Salary 135k Join ...

Socket.dev

Nurse Practitioner - OH

Cleveland, OH · On-site

$112 - $140/hr

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

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Freelance Hcc Risk Adjustment Coder information

What is a freelance HCC risk adjustment coder?

A Freelance HCC Risk Adjustment Coder is a healthcare professional who works independently to review medical records and assign appropriate ICD-10 codes based on Hierarchical Condition Categories (HCC). Their work supports accurate risk adjustment for insurance plans, particularly Medicare Advantage, by ensuring that patient diagnoses are properly documented and coded. This helps health plans receive correct reimbursement for the care of high-risk patients. Freelance coders have the flexibility to work with multiple clients and often work remotely.

What are the key skills and qualifications needed to thrive as a freelance HCC risk adjustment coder?

To thrive as a Freelance HCC Risk Adjustment Coder, you need a solid understanding of medical coding, ICD-10-CM classification, and risk adjustment models, typically backed by a coding certification such as CPC, CRC, or CCS. Familiarity with Electronic Health Record (EHR) systems, coding software, and payer-specific risk adjustment platforms is essential. Attention to detail, time management, and strong analytical and communication skills help you accurately review records and collaborate with healthcare providers. These skills ensure precise coding, optimize reimbursement, and maintain compliance in a remote, deadline-driven environment.

How does a freelance HCC risk adjustment coder typically collaborate with healthcare providers and coding teams remotely?

As a Freelance HCC Risk Adjustment Coder, you will often work independently but maintain regular communication with healthcare providers, auditors, and coding managers through secure online platforms, emails, or virtual meetings. You may be responsible for clarifying documentation, discussing complex coding scenarios, and providing feedback to providers to ensure accurate risk adjustment coding. Effective collaboration and clear communication are essential to resolve discrepancies and maintain compliance with regulatory standards. Most clients provide access to their electronic health record (EHR) systems and expect timely deliverables, so strong organizational and time management skills are important.

What is the difference between Freelance Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?

AspectFreelance Hcc Risk Adjustment CoderHcc Risk Adjustment Coder
CredentialsCertifications in medical coding, HCC coding experienceCertifications in medical coding, HCC coding experience
Work EnvironmentRemote, independent contractingTypically employed by healthcare organizations or coding companies
Employer & Industry UsageFreelance platforms, independent practiceHospitals, insurance companies, healthcare providers
Search & Comparison IntentLooking for freelance opportunities or contract workSeeking full-time or staff coding roles

Both roles require similar certifications and skills in HCC coding. The main difference is that a Freelance Hcc Risk Adjustment Coder works independently on a contract basis, often remotely, while an Hcc Risk Adjustment Coder is typically employed full-time by healthcare organizations. Your choice depends on your preferred work environment and employment type.

What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Ohio?

The most popular types of Hcc Risk Adjustment Coder jobs in Ohio are:

What are popular job titles related to Freelance Hcc Risk Adjustment Coder jobs in Ohio?

For Freelance Hcc Risk Adjustment Coder jobs in Ohio, the most frequently searched job titles are:

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The top searched job categories for Freelance Hcc Risk Adjustment Coder jobs in Ohio are:

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Cities in Ohio with the most Freelance Hcc Risk Adjustment Coder job openings:

Freelance Hcc Risk Adjustment Coder jobs near you

Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA)

Elevance Health

Mason, OH • On-site

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Elevance Health rating

7.5

Company rating: 7.5 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

217th of 315 rated insurance

Job description

Manager Clinical Performance & Quality (Nurse Practitioner/Physician Assistant)

Manager Clinical Performance & Quality Coding

LOCATION: The position requires that you be in the office 3x per week. You must be within a commutable distance of one of our eligible offices.

HOURS: General business hours, Monday through Friday (8-5 central)

Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Responsible for leading the quality documentation and value capture for all provider visit medical encounters to ensure application of accurate diagnosis codes (ICD-10 codes).

Primary duties include but not limited to:

  • Serves as the primary resource and subject matter expert on all CMS Risk Adjustment and quality documentation.
  • Develop and deliver clinical focused training on advance coding and documentation while incorporating coder feedback.
  • Liaison to the clinical leadership on alignment of goals and workflows to support value capture initiatives and high-quality clinical documentation.
  • Develop performance management plan, KPI's and clinical level tracking to meet quarterly goals for coding timeliness, accuracy, and Risk Adjustment.
  • Develop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures.
  • Develop operational and clinical workflows for closing HEDIS care opportunities to ensure practices and health plan success.
  • Participate in peer review of medical documentation for completed visits notes as well as patient profile information in EMR.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Required Qualifications

  • Current, active, valid, and unrestricted nurse practitioner (NP) or PA license in applicable state(s) required.
  • Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
  • Requires experience with CMS Risk Models.

Preferred Qualifications

  • You must have previous management/supervisory experience with direct reports.
  • HEDIS experience is preferred.
  • Experience with clinical data/documentation integrity is preferred (CDEO or CDEI).
  • Prefer AAPC Certified Risk Adjustment Coder (CRC) certification.

Job Level: Manager

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed Nurse

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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