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Hcc Risk Adjustment Medical Coder Jobs in Colorado

Valleyhealth

$41.30 - $51.62/hr

Familiarity with risk adjustment models, severity of illness (SOI), risk of mortality (ROM), and ... Medical/Prescription, Dental & Vision Discount Program (Full Time/Part Time Employees) * Group Term ...

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Hcc Risk Adjustment Medical Coder information

What is an HCC Risk Adjustment Medical Coder?

HCC Risk Adjustment Medical Coders are professionals who review and analyze medical records to assign appropriate ICD-10 codes for diagnoses and procedures. Their primary goal is to ensure accurate documentation for Hierarchical Condition Category (HCC) risk adjustment, which affects healthcare reimbursement and quality reporting for Medicare Advantage and other risk-based programs. These coders play a critical role in helping healthcare organizations receive appropriate payments and in supporting high-quality patient care by ensuring that all relevant health conditions are properly documented.

What skills and qualifications are needed to be an HCC Risk Adjustment Medical Coder?

To thrive as an HCC Risk Adjustment Medical Coder, you need a thorough understanding of ICD-10-CM coding, risk adjustment models, and healthcare regulations, typically supported by a coding certification such as CPC, CRC, or CCS. Proficiency with electronic health record (EHR) systems, coding software, and data analytics tools is essential for accurate documentation and reporting. Attention to detail, analytical thinking, and strong communication skills help coders interpret clinical documentation and collaborate with providers. These skills ensure accurate risk adjustment coding, which directly impacts healthcare reimbursement and compliance.

What are common challenges faced by HCC Risk Adjustment Medical Coders, and how can they be addressed?

HCC Risk Adjustment Medical Coders often encounter challenges such as interpreting complex patient records, keeping up with frequent updates to coding guidelines, and ensuring accurate capture of diagnoses for risk adjustment. To address these, coders benefit from strong attention to detail, regular training on ICD-10 and CMS risk adjustment updates, and effective communication with providers to clarify clinical documentation. Many coders also collaborate with auditing teams to resolve discrepancies and ensure compliance with regulatory standards, which helps maintain coding accuracy and data integrity.

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

AspectHcc Risk Adjustment Medical CoderMedical Coder
CertificationsCertified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC)Certified Professional Coder (CPC), Certified Coding Associate (CCA)
Work EnvironmentHealthcare facilities, insurance companies, risk adjustment teamsHospitals, clinics, physician offices
Industry UsageHealth plans, Medicare Advantage, MedicaidHospitals, outpatient clinics, physician practices

The main difference between an Hcc Risk Adjustment Medical Coder and a Medical Coder lies in their focus. Hcc Risk Adjustment Medical Coders specialize in risk adjustment coding for health plans, requiring knowledge of HCC models and risk scores. Medical Coders generally focus on clinical coding for billing and documentation across various healthcare settings. While both roles require coding certifications, Hcc Risk Adjustment Medical Coders have additional expertise in risk models and insurance industry standards.

Hcc Risk Adjustment Medical Coder jobs near you
Infographic showing various Hcc Risk Adjustment Medical Coder job openings in Colorado as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 88% Physical, 1% Hybrid, and 11% Remote job distribution.

Medical Coding Specialist - Certified (On-Site)

Sunrise Community Health

Evans, CO • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Certified Medical Coding Specialist

The Certified Medical Coding Specialist is responsible for correctly coding healthcare claims to obtain reimbursement from insurance companies and government health care programs. This position is an in-person position in the Monfort Family Clinic in Evans, Colorado.

Position Summary:

With a Quality, Customer First, and Compassionate approach, The Medical Coding Specialist will:

  • Analyze patient charts carefully to know the diagnosis and represent every item with specific codes.
  • Assign codes for diagnosis, treatments, and procedures according to the appropriate classification system.
  • Review claims data to ensure assigned codes meet required legal and insurance rules and that required authorizations are in place prior to submission.
  • Evaluate and re-file appeals for patient claims that were denied.
  • Ensure correct patient allocation is set.
  • Void any duplicate charges or charges entered in error.
  • Identify and report error patterns.
  • Notify coding supervisors of missing orders or needed documentation clarification.
  • Ensure timely and efficient billing of all electronic claim's submission.
  • Accurately enter payment and adjustments in the A/R system.
  • Collect health information as documented by medical providers and code them appropriately.
  • Consult medical providers for further clarification and understanding of items on patient charts to avoid any misinterpretations.
  • Provide accurate account information to patients about their A/R accounts and make any necessary corrections.
  • Comply with HIPAA, federal regulations, and Sunrise Community Health policies.

Minimum Qualifications:

  • High School Diploma.
  • Associate (AA) Degree and/or Certificate in Medical Coding.
  • Certified Professional Coder (CPC); preferred coding certification from AHIMA or AAPC.
  • 2 years' experience as a medical coder and/or training; or equivalent combination of education and experience.

Perks and Benefits:

At Sunrise, we pride ourselves in over 50 years of exceptional support to our community and employees. Sunrise is dedicated to guiding every employee towards professional growth and development by supporting them through training and tuition reimbursement. We value a healthy work life balance by providing generous paid time off. Employee opinions are valued, and we listen to employees through employee engagement surveys and the sharing of diverse ideas!

Sunrise Community Health offers a generous range of benefits based on working 30/hrs. or more per week.

Generous PTO and Leave Times:

  • Up to 8 weeks of Paid Time Off (Vacation, Personal, 12 Observed Holidays, and Sick Leave)

Health, Medical, and Wellness Benefits:

  • Medical Insurance
  • Dental & Vision Insurance
  • Basic Life & AD&D Insurance
  • Voluntary Life Insurance
  • Long-Term Disability (LTD)
  • FSA Medical Flexible Spending Account
  • FSA Dependent Care Spending Account
  • Employee Assistance Program

Financial Benefits:

  • Competitive 401K Plan
  • Loan Forgiveness Programs*
  • Employee Referral Bonus Program

Professional Development:

  • Tuition and Training Reimbursement
  • Agency Wide Training
  • Master Class Educational Tool

Get Involved:

  • Employee Recognition Programs

Current immunizations are required to work at Sunrise Community Health and may vary dependent upon the position. Influenza (Flu) is required for ALL staff. COVID vaccine is highly encouraged.

Sunrise Community Health is an Equal Opportunity Employer. We value a diverse, inclusive workforce that enriches our culture and our mission to provide affordable access to quality healthcare for all. Qualified applicants for employment will be considered without regard to an individual's race, color, sex, gender identity, gender expression, religion, age, national origin or ancestry, citizenship, physical or mental disability, medical condition, family care status, marital status, domestic partner status, sexual orientation, genetic information, military or veteran status, or any other basis protected by federal, state, or local laws. Accommodations are available for applicants with disabilities.

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