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Non Union Hcc Risk Adjustment Jobs (NOW HIRING)

Regal Medical Group, Inc.

$33 - $36/hr

Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and ... non-submittals (lab), ancillary, and pharmaceutical services for HCC values. * Perform both ...

Regal Medical Group, Inc.

$25 - $27/hr

Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and ... non-submittals (lab), ancillary, and pharmaceutical services for HCC values. * Perform both ...

Boston Medical Center

Risk Adjustment Coder

$19.25 - $25.50/hr

The Risk Adjustment Coder determines the appropriate ICD10-CM diagnoses codes based on clinical ... HCC's and other RA methodologies, ICD-10-CM coding guidelines, Office of Inspector General (OIG ...

Regal Medical Group

SR. HCC Coder

West Hills, CA · On-site

$30 - $33/hr

Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and ... non-submittals (lab), ancillary, and pharmaceutical services for HCC values. * Perform both ...

Pathways Health Partners

HCC Risk Coder

Leesburg, FL · On-site

$16.75 - $22.25/hr

An active CRC (certified risk adjustment coder) or CPC (certified professional coder) preferred. 2. ... MRA), HCC coding documentation guidelines, rules, and regulation. 4. Two years' demonstrated ...

Msmc

Certified Risk Adjustment Coder Senior

Campus, IL · On-site

$22 - $30/hr

Regularly reviews Epic HCC and payer reports. * Queries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment coding.

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All JobsNon Union Hcc Risk Adjustment Jobs

Non Union Hcc Risk Adjustment information

Is HCC coding a good career?

HCC coding, particularly in risk adjustment roles like Non Union HCC Risk Adjustment, is a growing field with steady demand due to the expansion of value-based healthcare. It requires knowledge of medical coding, clinical documentation, and often involves working with electronic health records; certifications such as CPC or CCS can enhance job prospects. The role offers opportunities for specialization and career advancement within healthcare administration and coding departments.

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

AspectNon Union Hcc Risk AdjustmentNon Union Medical Coder
CredentialsCertifications in risk adjustment, coding, or healthcare analyticsMedical coding certifications (CPC, CCS, etc.)
Work EnvironmentInsurance companies, healthcare analytics firms, or risk adjustment departmentsHospitals, clinics, or medical billing companies
Industry UsageFocuses on risk scoring for insurance reimbursement and healthcare planningFocuses on translating medical records into codes for billing and documentation

Non Union Hcc Risk Adjustment specialists primarily analyze health data to optimize risk scores for insurance purposes, while Non Union Medical Coders focus on accurately coding medical records for billing. Both roles require healthcare certifications but differ in their core functions and work settings.

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Non Union Hcc Risk Adjustment jobs near you
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

North East Medical Services

Burlingame, CA • On-site

$42.79 - $48.75/hr

Other

Posted 23 days ago

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance.
ESSENTIAL JOB FUNCTIONS:
  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor

  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required.
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:
  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:
  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position.

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