The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
Ambulatory Clinical Documentation Integrity Specialist (Remote)
Livonia, MI · Remote
$32.50 - $43.75/hr
... HCC risk adjustment, ensuring compliance with reporting standards for claims submission. * Identifies patterns & trends impacting documentation & coding & acts as a technical resource related to ...
Ambulatory Clinical Documentation Integrity Specialist (Remote)
Livonia, MI · Remote
$32.50 - $43.75/hr
... HCC risk adjustment, ensuring compliance with reporting standards for claims submission. * Identifies patterns & trends impacting documentation & coding & acts as a technical resource related to ...
Ambulatory Clinical Documentation Integrity Specialist (Remote)
Livonia, MI · On-site +1
$32.50 - $43.75/hr
... HCC risk adjustment, ensuring compliance with reporting standards for claims submission. * Identifies patterns & trends impacting documentation & coding & acts as a technical resource related to ...
Ambulatory Clinical Documentation Integrity Specialist (Remote)
Livonia, MI · On-site +1
$32.50 - $43.75/hr
... HCC risk adjustment, ensuring compliance with reporting standards for claims submission. * Identifies patterns & trends impacting documentation & coding & acts as a technical resource related to ...
Ambulatory Clinical Documentation Integrity Specialist (Remote)
Livonia, MI · Remote
$32.50 - $43.75/hr
... HCC risk adjustment, ensuring compliance with reporting standards for claims submission. * Identifies patterns & trends impacting documentation & coding & acts as a technical resource related to ...
Ambulatory Clinical Documentation Integrity Specialist (Remote)
Livonia, MI · Remote
$32.50 - $43.75/hr
... HCC risk adjustment, ensuring compliance with reporting standards for claims submission. * Identifies patterns & trends impacting documentation & coding & acts as a technical resource related to ...
HCC Coder
Midland, MI · On-site
$16 - $21.50/hr
... Risk Adjustment Factor (RAF) scores (25%) Understands risk adjusted payment methodologies, HCC assignment and payment methodology, professional coding and billing, outpatient facility coding and ...
HCC Coder
Midland, MI · On-site
$16 - $21.50/hr
... Risk Adjustment Factor (RAF) scores (25%) Understands risk adjusted payment methodologies, HCC assignment and payment methodology, professional coding and billing, outpatient facility coding and ...
... standards, coding compliance, HCC/Risk Adjustment, and revenue integrity. Your leadership will influence enterprise-wide initiatives, shape system design, and drive consistent, high-quality ...
... standards, coding compliance, HCC/Risk Adjustment, and revenue integrity. Your leadership will influence enterprise-wide initiatives, shape system design, and drive consistent, high-quality ...
... standards, coding compliance, HCC/Risk Adjustment, and revenue integrity. Your leadership will influence enterprisewide initiatives, shape system design, and drive consistent, highquality ...
... standards, coding compliance, HCC/Risk Adjustment, and revenue integrity. Your leadership will influence enterprisewide initiatives, shape system design, and drive consistent, highquality ...
To assist the Revenue Management and Risk Adjustment department (RMRA) in ensuring the Financial ... Union Code: Not Applicable
To assist the Revenue Management and Risk Adjustment department (RMRA) in ensuring the Financial ... Union Code: Not Applicable
To assist the Revenue Management and Risk Adjustment department (RMRA) in ensuring the Financial ... Union Code: Not Applicable
To assist the Revenue Management and Risk Adjustment department (RMRA) in ensuring the Financial ... Union Code: Not Applicable
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Monitor quality, cost, utilization, and risk-adjustment metrics tied to APM performance ... Union Code: Not Applicable
Monitor quality, cost, utilization, and risk-adjustment metrics tied to APM performance ... Union Code: Not Applicable
Develops and presents PHO/PO reports related to risk adjustment, quality including HEDIS/Medicare 5 ... Union Code: Not Applicable
Develops and presents PHO/PO reports related to risk adjustment, quality including HEDIS/Medicare 5 ... Union Code: Not Applicable
Develops and presents PHO/PO reports related to risk adjustment, quality including HEDIS/Medicare 5 ... Union Code: Not Applicable
Develops and presents PHO/PO reports related to risk adjustment, quality including HEDIS/Medicare 5 ... Union Code: Not Applicable
Auditor and Educator - Professional Services/Remote
Livonia, MI · On-site +1
$25.25 - $28.75/hr
Must possess comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, medical terminology ... Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), Clinical Documentation ...
Auditor and Educator - Professional Services/Remote
Livonia, MI · On-site +1
$25.25 - $28.75/hr
Must possess comprehensive knowledge of ICD-10, HCPCS, CPT, and HCC guidelines, medical terminology ... Certified Professional Medical Auditor (CPMA), Certified Risk Coder (CRC), Clinical Documentation ...
EverCare Nurse Practitioner
Kalamazoo, MI · On-site
... and coding standards, risk adjustment accuracy, and practice metrics. • Participates in the on-call schedule per on-call policy, providing telephone management and visits as needed. Essential ...
EverCare Nurse Practitioner
Kalamazoo, MI · On-site
... and coding standards, risk adjustment accuracy, and practice metrics. • Participates in the on-call schedule per on-call policy, providing telephone management and visits as needed. Essential ...
EverCare Nurse Practitioner
Kalamazoo, MI · On-site
... and coding standards, risk adjustment accuracy, and practice metrics. • Participates in the on-call schedule per on-call policy, providing telephone management and visits as needed. Essential ...
EverCare Nurse Practitioner
Kalamazoo, MI · On-site
... and coding standards, risk adjustment accuracy, and practice metrics. • Participates in the on-call schedule per on-call policy, providing telephone management and visits as needed. Essential ...
Performance improvement opportunities in the areas of quality, utilization, risk adjustment, and ... Union Code: Not Applicable
Performance improvement opportunities in the areas of quality, utilization, risk adjustment, and ... Union Code: Not Applicable
Senior Consultant - Clinical Documentation Specialist
$34.50 - $46.25/hr
Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment * Other ... risk adjustment * Has strong interpersonal skills to collaborate with clinicians, physicians, NP ...
Senior Consultant - Clinical Documentation Specialist
$34.50 - $46.25/hr
Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment * Other ... risk adjustment * Has strong interpersonal skills to collaborate with clinicians, physicians, NP ...
Hcc Risk Adjustment Coding information
What are the key skills and qualifications needed to thrive in the Hcc Risk Adjustment Coding position, and why are they important?
To thrive as an HCC Risk Adjustment Coder, you need a strong understanding of medical coding guidelines, ICD-10-CM codes, and risk adjustment principles, typically supported by a certification such as CPC, CRC, or CCS-P. Familiarity with electronic health record systems and risk adjustment software is essential for accurate coding and data analysis. Attention to detail, critical thinking, and effective communication skills are important soft skills for ensuring documentation integrity and collaborating with healthcare providers. These competencies are crucial to accurately capture patient complexity, optimize reimbursement, and support compliance in healthcare organizations.
What are the typical challenges faced by HCC Risk Adjustment Coders, and how can they overcome them?
HCC Risk Adjustment Coders often face challenges such as interpreting complex medical records, staying up-to-date with evolving coding guidelines, and ensuring thorough documentation to support accurate risk scoring. To overcome these challenges, coders should engage in continuous education, collaborate closely with healthcare providers for clarification, and utilize available coding resources and team support. Staying organized and maintaining a detail-oriented approach will also help ensure that codes are assigned correctly and all relevant conditions are captured. Working as part of a supportive team can further ease the process, providing opportunities for knowledge sharing and professional development.
What is an HCC Risk Adjustment Coding job?
An HCC Risk Adjustment Coding job involves reviewing medical records to assign Hierarchical Condition Category (HCC) codes based on documented diagnoses. Coders ensure accurate risk adjustment by following ICD-10-CM coding guidelines, which impact reimbursement for healthcare providers and insurance plans. This role requires knowledge of medical terminology, compliance regulations, and risk adjustment models used in Medicare Advantage and other programs.

Full-time
Posted 26 days ago
Holland Hospital rating
6.6
Based on 32 frontline employees who took The Breakroom Quiz
650th of 1,004 rated hospitals
Job description
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.
Qualifications:
Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hire
Experience with risk adjustment programs preferred.
Prior provider education or clinical collaboration experience preferred.
Excellent communication skills for provider education and stakeholder collaboration
Employment Type: Full Time
Shift: Mon-Thrs- 8am-4:30pm Fri- 8a-12p
Weekly Scheduled Hours: 36
Weekend Requirements: NA
Requirements:
- High school diploma/GED or higher education
-Certified Professional Coder (C-CPC)
Clinical Documentation Review & Risk Adjustment Coding
- Prepare and manage risk adjustment visit workflows, including maintaining patient lists, diagnosis summaries, and assisting with scheduling coordination.
- Conduct comprehensive pre-visit chart reviews to identify and validate ICD-10-CM diagnoses that accurately represent each patient's health status.
- Perform post-visit documentation analysis to ensure proper ICD-10-CM code assignment, diagnosis specificity, and compliance with MEAT (Monitor, Evaluate, Assess, Treat) criteria.
- Maintain up-to-date knowledge of CMS risk adjustment regulations, HCC models, and clinical documentation and coding standards.
- Support organizational value-based care goals by collaborating with Manager, Quality and clinical teams to ensure compliant risk adjustment documentation.
Provider Engagement, Education & Clinical Support
- Serve as a clinical documentation and coding subject matter expert, supporting providers in achieving compliant and accurate risk adjustment practices.
- Deliver ongoing education and feedback to providers and coders regarding documentation standards, diagnosis specificity, and optimal risk adjustment coding principles.
- Identify documentation gaps or inconsistencies and communicate findings through structured, actionable feedback, including formalized documentation queries as needed.
- Promote a culture of documentation excellence that supports quality outcomes, operational performance, and compliant value-based care delivery.
Audit, Reporting & Performance Monitoring
- Conduct routine and targeted chart audits to assess documentation quality, coding accuracy, and HCC recapture performance.
- Track, analyze, and report key risk adjustment performance indicators, including recapture rates, suspect condition closure, documentation accuracy, and provider-level trends.
- Collaborate with operational leaders to integrate risk adjustment best practices into existing clinical workflows and identify opportunities for process improvement.
- Participate in quality assurance initiatives, report findings to leadership, and support the development of corrective action plans or workflow enhancements.
Holland Hospital is an Equal Opportunity Employer, please see our EEO policy
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