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Hcc Coders Jobs in Washington (NOW HIRING)

HealthCare Resolution Services

Medical Coder

Columbia, MD · Remote

$19.25 - $25.50/hr

As an HCC Coding Analyst, you will play a vital role in ensuring accurate documentation and coding of patient records to optimize reimbursement from government programs such as the Centers for ...

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Hcc Coders information

What are HCC Coders?

HCC Coders are healthcare professionals who review and analyze patient medical records to assign accurate Hierarchical Condition Category (HCC) codes. These codes are used primarily for risk adjustment in Medicare Advantage and other value-based care programs, ensuring that healthcare providers receive appropriate reimbursement based on the complexity of their patients' conditions. HCC Coders must have a thorough understanding of medical terminology, coding guidelines, and regulatory requirements. Their work helps ensure the integrity of healthcare data and compliance with government regulations.

What are the key skills and qualifications needed to thrive as an HCC Coder, and why are they important?

To thrive as an HCC Coder, you need a solid understanding of medical coding, risk adjustment, and healthcare regulations, typically supported by certifications such as CPC or CRC. Familiarity with coding software, electronic health records (EHRs), and ICD-10-CM coding systems is essential. Attention to detail, analytical thinking, and effective communication help ensure accurate code assignment and collaboration with healthcare providers. These skills are crucial for optimizing reimbursement, ensuring compliance, and maintaining data integrity in healthcare organizations.

What are some common challenges HCC Coders face in ensuring accurate and compliant coding?

HCC Coders often encounter challenges such as interpreting complex medical records, staying current with changing coding guidelines, and ensuring accurate risk adjustment coding for reimbursement purposes. Maintaining compliance with regulations while meeting productivity standards can be demanding, especially when documentation from providers is insufficient or unclear. Collaborating effectively with physicians and clinical staff is essential to clarify diagnoses and ensure all relevant conditions are captured for accurate coding.

What Does an HCC Coder Do?

An HCC coder, or hierarchical condition category coder, is someone who transcribes a patient’s medical history into a database using standardized codes. This includes diagnosis and treatment and is typically later used for insurance and medical billing purposes. As an HCC coder, you may go over a patient’s records to ensure accuracy and audit records and documentation to ensure the entering of codes was correct. You typically work in a hospital or other health care setting. There are several different jobs that fall into the HCC coder category, such as specialist, manager, trainer, auditor, and analyst.

What is the difference between Hcc Coders vs Medical Coders?

AspectHcc CodersMedical Coders
CertificationsHCC Coding Certification, Medical Coding CertificationCertified Professional Coder (CPC), Certified Coding Specialist (CCS)
Work EnvironmentHospitals, clinics, insurance companiesHospitals, physician offices, outpatient facilities
Industry UsageRisk adjustment, insurance billingMedical billing, claims processing
Search & Comparison IntentFocus on risk adjustment and insurance codingFocus on medical billing and claims

Hcc Coders primarily focus on risk adjustment coding for insurance purposes, requiring specific certifications and working mainly in insurance-related environments. Medical Coders handle billing and claims in healthcare settings, with different certifications. While both roles involve coding, Hcc Coders specialize in risk adjustment, whereas Medical Coders focus on medical billing processes.

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Hcc Coders jobs near you
Infographic showing various Hcc Coders job openings in Washington as of July 2026, with employment types broken down into 80% Full Time, 16% Part Time, 3% Contract, and 1% Nights. Highlights an 67% Physical, 1% Hybrid, and 32% Remote job distribution.

HCC Coding Validation Specialists

HealthCare Resolution Services

Columbia, MD • On-site

Contractor

Posted 26 days ago

Job description


Job Overview
We are seeking a highly skilled and detail-oriented HCC Coding Analyst to join our healthcare revenue cycle management team. The ideal candidate will possess a comprehensive understanding of hierarchical condition categories (HCC) coding, medical billing, and medical record abstraction. As an HCC Coding Analyst, you will play a vital role in ensuring accurate documentation and coding of patient records to optimize reimbursement from government programs such as the Centers for Medicare and Medicaid Services (CMS). Your expertise in ICD-9, ICD-10, CPT coding, and DRG assignment will contribute significantly to the efficiency and compliance of our billing processes. This position offers an opportunity to work within a dynamic healthcare environment dedicated to accuracy, compliance, and quality patient care.
Duties
  • Review NLP-generated HCC coding output.
  • Validate assigned codes against available documentation.
  • Identify unsupported, inaccurate, or missing codes.
  • Make corrections in the platform or designated workflow.
  • Follow customer coding instructions and project guidelines.
  • Complete assigned records in accordance with agreed production expectations.
  • Utilize electronic health record (EHR) systems and electronic health records (EHR) management tools for coding, record abstraction, and billing workflows.
  • Conduct audits of coded records to identify discrepancies and implement corrective actions to improve coding accuracy.
  • Maintain up-to-date knowledge of changes in medical coding standards, CMS regulations, and healthcare policies affecting reimbursement.
  • Support revenue cycle management initiatives by ensuring precise coding that maximizes appropriate reimbursements while maintaining compliance.

Requirements
  • Proven experience in medical coding with a focus on HCC coding within a healthcare setting.
  • Strong knowledge of ICD-9, ICD-10, CPT coding systems, and DRG assignment processes.
  • Familiarity with medical billing procedures, medical records management, and electronic health record (EHR) systems.
  • Understanding of the CMS guidelines for risk adjustment models and reimbursement policies.
  • Excellent attention to detail with the ability to accurately abstract information from complex medical records.
  • Knowledge of medical terminology, anatomy, pathology, and clinical documentation practices.
  • Prior experience with electronic health records (EHR) management for billing and coding is highly desirable.
  • Effective communication skills for collaborating with clinicians, billing teams, and auditors.

Join our team as an HCC Coding Analyst to ensure precise clinical documentation that supports optimal reimbursement while maintaining regulatory compliance within a fast-paced healthcare environment!
Benefits:
  • Flexible schedule
  • Work Location: Remote

Apply