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Seasonal Hcc Risk Adjustment Coding Jobs in Missouri

$24.25 - $27.50/hr

... including HCC's (e.g., CMS, OIG, MAC guidelines). Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations.

$27 - $30.75/hr

... standards including HCC's (e.g., CMS, OIG, MAC guidelines). • Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and ...

$24.25 - $27.50/hr

... HCC's (e.g., CMS, OIG, MAC guidelines). · Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations. · Collaborate ...

$24.25 - $27.50/hr

... standards including HCC's (e.g., CMS, OIG, MAC guidelines). • Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and ...

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...

Showing results 21-40

Seasonal Hcc Risk Adjustment Coding information

What is a seasonal HCC risk adjustment coder?

A Seasonal HCC Risk Adjustment Coder is a healthcare professional who reviews medical records to identify and code diagnoses that impact risk adjustment scores, typically during peak periods such as the Medicare Advantage sweep season. HCC stands for Hierarchical Condition Category, a coding system used by Medicare to predict healthcare costs based on patient diagnoses. These coders ensure accurate documentation, which directly affects insurance reimbursement and compliance. Seasonal roles are common due to the cyclical nature of risk adjustment reporting deadlines.

What are the key skills and qualifications needed to thrive as a seasonal HCC risk adjustment coder?

To thrive as a Seasonal HCC Risk Adjustment Coder, you need a strong understanding of ICD-10-CM coding, risk adjustment methodologies, and a certification such as CPC, CRC, or CCS. Proficiency in coding software, electronic health records (EHRs), and risk adjustment platforms is typically required. Attention to detail, analytical thinking, and strong organizational skills help ensure accuracy and compliance in reviewing medical records. These skills are essential to accurately capture patient risk profiles, support healthcare reimbursement, and maintain regulatory compliance.

What are the most common challenges faced by professionals in seasonal HCC risk adjustment coding roles, and how can they be managed?

Seasonal HCC Risk Adjustment Coders often face the challenge of managing high volumes of medical records within tight deadlines, especially during peak audit or submission periods. Ensuring coding accuracy and compliance with evolving CMS guidelines can also be demanding, as even minor errors may impact reimbursement and risk scores. Staying organized, regularly participating in training updates, and leveraging coding software tools can help manage workloads and maintain accuracy. Collaborating closely with clinical teams and other coders is vital for clarifying documentation and sharing best practices.

What is the difference between Seasonal Hcc Risk Adjustment Coding vs Hcc Risk Adjustment Coding?

AspectSeasonal Hcc Risk Adjustment CodingHcc Risk Adjustment Coding
CredentialsCertifications in coding and risk adjustmentCertifications in coding and risk adjustment
Work EnvironmentHealthcare facilities, insurance companies, remoteHealthcare facilities, insurance companies, remote
Industry UsageUsed seasonally for specific risk adjustmentsUsed year-round for ongoing risk management
Search IntentUnderstanding seasonal coding differencesGeneral risk adjustment coding practices

Seasonal Hcc Risk Adjustment Coding focuses on coding practices during specific times of the year, often related to seasonal health trends. In contrast, Hcc Risk Adjustment Coding involves continuous coding to manage patient risk profiles throughout the year. Both roles require similar certifications and work environments but differ mainly in their temporal focus and application.

What are popular job titles related to Seasonal Hcc Risk Adjustment Coding jobs in Missouri?

For Seasonal Hcc Risk Adjustment Coding jobs in Missouri, the most frequently searched job titles are:

What job categories do people searching Seasonal Hcc Risk Adjustment Coding jobs in Missouri look for?

The top searched job categories for Seasonal Hcc Risk Adjustment Coding jobs in Missouri are:

What cities in Missouri are hiring for Seasonal Hcc Risk Adjustment Coding jobs?

Cities in Missouri with the most Seasonal Hcc Risk Adjustment Coding job openings:

Senior Business Technical Analyst

Centene

Saint Louis, MO

$87K - $157K/yr

Full-time

Medical, Retirement, PTO

Posted 3 days ago

New


Centene rating

8.4

Company rating: 8.4 out of 10

Based on 404 frontline employees who took The Breakroom Quiz

14th of 889 rated healthcare providers


Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA Prioritization and Encounter RA Chart Process support. The ideal candidate brings advanced SAS, SQL, Snowflake, healthcare data integration, data quality, regulatory compliance, and reusable documentation experience.

  • Partners with business analysts, Risk Adjustment stakeholders, IT, and vendor teams to understand provided Medicare Advantage and Medicaid business requirements, translate them into technical specifications, and support process improvements through SAS solutions and future Snowflake capabilities.
  • Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment Prioritization and Encounter Risk Adjustment Chart Process workflows, with future Snowflake migration support.
  • Creates multi-user, real-time, robust database solutions by integrating complex healthcare datasets, including claims, enrollment, provider, pharmacy, clinical records, and vendor chart data.
  • Acts as a technical subject matter expert to convert provided business requirements into system analysis, technical design, advanced SAS/SQL programming, Snowflake modernization, and documentation of business applications/systems.
  • Modernizes legacy SAS ETL workflows into scalable Snowflake architecture using Snowflake SQL, Snowpark Python, and automated pipeline orchestration concepts such as Tasks and Streams
  • Implements validation, reconciliation, and data quality frameworks to support CMS audit standards, state Medicaid requirements, and compliant Risk Adjustment encounter submissions.
  • Builds reusable SAS, SQL, and Snowflake data assets, modular code libraries, and technical documentation to reduce development time and support knowledge transfer across data and actuarial teams.
  • Develops ad-hoc reports to conduct data analysis and validation.
  • Confers with area/department to analyze current operational procedures and trends and identify problems.
  • Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the organization's goals.
  • Research, evaluate and assess the financial impact of issues identified in data/processes.
  • Analyzes requirements, procedures, and problems to automate processing or to improve existing business systems.
  • Creates multiuser, real-time, robust database solutions.
  • Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, technical design, programming and documentation of business applications/systems.
  • May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies.
  • Provides oversight and resolves complex issues, optimizing performance, resolving problems, and providing timely follow-up on identified issues.
  • Provides guidance and training to staff on process, procedures and issue resolution.
  • Complies with all policies and standards

Education/Experience:


Requires a Bachelor's Degree in a related field:

Required or equivalent work experience in technical data analysis, conducting system analysis meetings, developing system design documents, developing project plans with achievable milestones and deadlines, and mediating different department demands to gain approvals on system scope and design.

Preferred Experience:

  • Master's degree in a related field, i.e., Mathematics, Computer Science, etc may be considered in lieu of some of the required experience (not to exceed 2 years)
  • 1+ year of experience in Healthcare
  • 4+ years of experience in relevant programming to include SAS, SQL, Snowflake
  • Experience with Medicare Advantage, Medicaid, Risk Adjustment, encounter submissions, claims, enrollment, provider, pharmacy, clinical, and vendor chart data.
  • Experience modernizing SAS ETL workflows into Snowflake using Snowflake SQL, Snowpark Python, and automated pipeline orchestration
  • 3+ years of experience in related business analysis
  • 1+ year of experience in ASP/ASP.NET


Licenses and Certifications :

A license in one of the following is preferred:

  • Preferred SAS Certified Professional or SAS Certification.
  • Preferred SnowPro Certification.
Pay Range: $87,700.00 - $157,800.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act


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