PHYSICIAN ADVISOR
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
Dayton, OH · On-site
This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Columbus, OH · Hybrid
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Columbus, OH · Hybrid
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Columbus, OH · On-site
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
Columbus, OH · On-site
Certified Risk Adjustment Coder (CRC) or Certified Documentation Integrity Practitioner (CDIP), preferred. Skills: * Proficiency with LMS platforms and virtual training tools. * Proficiency with EPIC ...
$33.25 - $44.75/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 ...
$33.25 - $44.75/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 ...
Dayton, OH · On-site +1
... expertise and code reviews. Essential Functions: * Evaluate emerging technology in LLMs, NLP ... Work closely with interdisciplinary teams across IT, risk adjustment, program integrity, HEDIS ...
Dayton, OH · On-site +1
... expertise and code reviews. Essential Functions: * Evaluate emerging technology in LLMs, NLP ... Work closely with interdisciplinary teams across IT, risk adjustment, program integrity, HEDIS ...
Completes adjustment entry and credits reconciliation in a timely and accurate manner including ... Maintains professional knowledge regarding medical billing and coding procedures, insurance ...
Completes adjustment entry and credits reconciliation in a timely and accurate manner including ... Maintains professional knowledge regarding medical billing and coding procedures, insurance ...
Completes adjustment entry and credits reconciliation in a timely and accurate manner including ... Maintains professional knowledge regarding medical billing and coding procedures, insurance ...
Completes adjustment entry and credits reconciliation in a timely and accurate manner including ... Maintains professional knowledge regarding medical billing and coding procedures, insurance ...
Dayton, OH · On-site
$120K - $140K/yr
... HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). (preferred) For more information contact:
Dayton, OH · On-site
$120K - $140K/yr
... HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). (preferred) For more information contact:
Dayton, OH · On-site
$120K - $140K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). (preferred) To learn more contact:
Quick apply
Dayton, OH · On-site
$120K - $140K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). (preferred) To learn more contact:
Moraine, OH · On-site
Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. * Provide coverage for the 24/7 on-call rotation, addressing ...
Moraine, OH · On-site
Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. * Provide coverage for the 24/7 on-call rotation, addressing ...
Moraine, OH · On-site
Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. * Provide coverage for the 24/7 on-call rotation, addressing ...
New
Moraine, OH · On-site
Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. * Provide coverage for the 24/7 on-call rotation, addressing ...
New
Dayton, OH · On-site
Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. * Provide coverage for the 24/7 on-call rotation, addressing ...
Quick apply
Dayton, OH · On-site
Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. * Provide coverage for the 24/7 on-call rotation, addressing ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Akron, OH · On-site
$105K - $140K/yr
Understanding of HCC documentation, ICD-10 coding, and Health Risk Assessments preferred About Us Titan Placement Group is a permanent placement healthcare recruiting firm dedicated to connecting ...
Youngstown, OH · On-site
$87K - $187K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Youngstown, OH · On-site
$87K - $187K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
$12.60 - $15.19
0% of jobs
$15.19 - $17.79
17% of jobs
$19.05 is the 25th percentile. Wages below this are outliers.
$17.79 - $20.39
17% of jobs
The median wage is $22.62 / hr.
$20.39 - $22.99
19% of jobs
$22.99 - $25.58
9% of jobs
$25.58 - $28.18
7% of jobs
$29.88 is the 75th percentile. Wages above this are outliers.
$28.18 - $30.78
8% of jobs
$30.78 - $33.37
6% of jobs
$33.37 - $35.97
4% of jobs
$35.97 - $38.57
6% of jobs
$38.57 - $41.16
5% of jobs
$12
$25
$41
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.
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.
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.

The Physician Advisor - CDI, Coding & Quality serves as a key clinical leader supporting Premier Health's goals to advance documentation accuracy, revenue integrity, and quality performance across the health system. This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams.
The Physician Advisor provides expert second-level reviews, leads provider education, and partners closely with the CDI Manager, Coding Manager and interdisciplinary teams to ensure that documentation accurately reflects the clinical complexity, severity of illness, and quality outcomes of Premier Health's patient population.
Provide secondary review of complex CDI and Coding queries escalated by the CDI and Coding teams.
Review and resolve escalations involving Query disagreement, Clinical Validation, or incomplete response.
Partner with the CDI Manager to establish standardized escalation criteria and ensure timely resolution of all high-impact queries.
Conduct focused "second-look" reviews of no-CC/MCC or CC-only cases to identify missed documentation opportunities and support CMI improvement.
Serve as a liaison between the CDI, Coding, and Physician teams to promote consistency in documentation practices.
Conduct one-on-one meetings with providers to review query metrics, patterns, and opportunities for improvement.
Deliver targeted education sessions on documentation best practices, MCC/CC capture, and quality measure alignment.
Participate in residency and faculty education (Internal Medicine, Family Practice, Trauma, Critical Care, etc.) including lectures and QIPS elective rotations on CDI and professional billing documentation.
Partner with the CDI Manager and Quality leadership to develop and disseminate system-wide education tools and tip sheets.
Analyze and communicate CMI trends by service line; support interventions to drive improvement aligned with Vizient benchmarks.
Collaborate with Digital Health team to refine dashboards and enable data-driven improvement strategies.
Participate in pre-claim mortality and risk adjustment reviews, focusing on REM score optimization and accurate capture of clinical risk variables.
Support PSI/HAC reviews from a CDI perspective in partnership with Quality and CDI teams.
Serve as a clinical resource to the CDI, Coding, and Quality departments on complex documentation and regulatory compliance questions.
Partner with Digital Health to support AI-enabled CDI nudges, EHR workflow optimization, and system note-template refinement and creation for service lines.
Contribute to system-wide initiatives related to mortality O/E, LOS O/E, and cost efficiency performance, Vizient facility ranking and Elix Hauser risk adjustment methodologies.
Achieve a sizeable conversion rate on escalated CDI/Coding queries.
Demonstrate measurable CMI improvement in targeted service lines.
Support system improvement in key Vizient metrics (Mortality O/E, Cost O/E, LOS O/E).
Maintain provider query agreement rate 80% and consistent educational engagement.
Qualifications
Education: Doctor of Medicine (MD) or Doctor of Osteopathy (DO) required.
Licensure: Active Ohio medical license (or eligibility for licensure).
Experience:
- Minimum 3 years of clinical practice experience.
- Prior involvement in CDI, and or quality improvement preferred 1-2 years' experience
- Strong working knowledge of ICD-10, MS-DRG/APR-DRG systems, and risk adjustment models Vizient, CMS, Elixhauser etc.
Skills:
- Excellent communication and teaching skills.
- Ability to interpret clinical and coding guidelines with precision.
- Proficiency with EHR systems (Epic experience preferred).