... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
Remote - HCC Medical Coder
Independence, OH · On-site
$18.25 - $24.50/hr
The Hierarchical Condition Category (HCC) Medical Coder is responsible for assigning ICD-10-CM diagnosis codes and/or HCC's as appropriate to reflect risk adjustment and abstracts pertinent ...
Remote - HCC Medical Coder
Independence, OH · On-site
$18.25 - $24.50/hr
The Hierarchical Condition Category (HCC) Medical Coder is responsible for assigning ICD-10-CM diagnosis codes and/or HCC's as appropriate to reflect risk adjustment and abstracts pertinent ...
Consulting Actuary - ACA Risk Adjustment
$143.62K - $229.79K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Consulting Actuary - ACA Risk Adjustment
$143.62K - $229.79K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... Risk Adjustment initiatives. May require some travel to various provider partner locations Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model. Develop an understanding ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... Risk Adjustment initiatives. May require some travel to various provider partner locations Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model. Develop an understanding ...
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.
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.
HIM Coder - Professional
Portsmouth, OH · On-site
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.
HIM Coder - Professional
Portsmouth, OH · On-site
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.
Revenue Cycle Coordinator
Cincinnati, OH · On-site
The Revenue Cycle Coordinator is responsible for accurate coding, charge review, risk-adjustment ... HCC) and communicate documentation needs to providers. • Conduct ongoing coding audits and ...
Revenue Cycle Coordinator
Cincinnati, OH · On-site
The Revenue Cycle Coordinator is responsible for accurate coding, charge review, risk-adjustment ... HCC) and communicate documentation needs to providers. • Conduct ongoing coding audits and ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Nephrology Nurse Practitioner
Cleveland, OH · On-site
$107.70K - $147.90K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Nephrology Nurse Practitioner
Cleveland, OH · On-site
$107.70K - $147.90K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Nephrology Nurse Practitioner
Akron, OH · On-site
$106.20K - $145.90K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Nephrology Nurse Practitioner
Akron, OH · On-site
$106.20K - $145.90K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Nephrology Nurse Practitioner
Dayton, OH · On-site
$97.80K - $134.40K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Nephrology Nurse Practitioner
Dayton, OH · On-site
$97.80K - $134.40K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Family Practice/Primary Care Nurse Practitioner
Cleveland, OH · On-site
$99.40K - $135.80K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Family Practice/Primary Care Nurse Practitioner
Cleveland, OH · On-site
$99.40K - $135.80K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Family Practice/Primary Care Nurse Practitioner
Dayton, OH · On-site
$90.30K - $123.40K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Family Practice/Primary Care Nurse Practitioner
Dayton, OH · On-site
$90.30K - $123.40K/yr
Document using the DSP framework (specific diagnosis with stage/type/complications, clinical status, active plan) to support accurate risk adjustment and HCC capture. * Ensure annual recapture of CKD ...
Freelance Hcc Risk Adjustment Coder information
What are the key skills and qualifications needed to thrive as a Freelance HCC Risk Adjustment Coder, and why are they important?
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 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 is the difference between Freelance Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?
| Aspect | Freelance Hcc Risk Adjustment Coder | Hcc Risk Adjustment Coder |
|---|---|---|
| Credentials | Certifications in medical coding, HCC coding experience | Certifications in medical coding, HCC coding experience |
| Work Environment | Remote, independent contracting | Typically employed by healthcare organizations or coding companies |
| Employer & Industry Usage | Freelance platforms, independent practice | Hospitals, insurance companies, healthcare providers |
| Search & Comparison Intent | Looking for freelance opportunities or contract work | Seeking 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.
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Kettering Health rating
7.3
Based on 181 frontline employees who took The Breakroom Quiz
290th of 864 rated healthcare providers
Job description
Physician Office | Kettering | Full-Time | First Shift
Responsibilities & Requirements
This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation.
KPN Pro Fee Coding Specialist
Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
- Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
- Reviewing the ambulatory records for the appropriate risk adjustment components
- Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes
- Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
- Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy]
- Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
- Corresponds with providers on pending claims to facilitate resolution
- Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
- Communicate appropriately with providers, leaders, and staff
- Researches and resolves concerns timely
The Risk Adjustment Coder is responsible for coding and abstracting all outpatient patient records using ICD-10-CM and CPT/HCPCS coding rules, federal guideline and KMCN guidelines. Additionally, the Risk Adjustment Coder supports hospital’s accounts receivable goals through timely processing of records and physician record completion activities. Impacts delivery of quality patient care and enhanced clinical decision-making process. Supports clinical outcomes measurement and assessment process for service lines. Completes assigned duties and other related tasks. The list is not inclusive, Performs other duties as assigned.
The Risk Adjustment Coder will supplement the educational offerings of the MSO by providing right-time feedback to providers when documenting or coding the risk adjustment on patient records. The Risk Adjustment Coder will contribute to overarching educational efforts of the MSO regarding Risk Adjustment. The Risk Adjustment Coder will offer summarized content, feedback from providers, key barriers or success efforts to executive leaders to assist in the overall risk adjustment of the population.
The Risk Adjustment Coder will spend some in-person time with providers to foster a relationship and encourage dialogue with risk adjustment to improve overall outcomes. The Risk Adjustment Coder will develop a collegial relationship with the Clinical Documentation Specialist RN (CDS) to partner on the overarching risk adjustment of the population.
Educational Requirements:
High School Diploma or equivalent
RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification
Prior experience in professional fee coding/billing
CRC required within 1 year of hire
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.
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