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Seasonal Hcc Risk Adjustment Coding Jobs in Canton, MI

Theoria Medical

Director, Data & BI

Novi, MI · On-site

... on measure calculation, risk adjustment and HCC capture, and readmissions * AI in the Stack ... standards for code review, documentation, and delivery quality Qualifications Experience ...

Strive Health

Nurse Practitioner

Royal Oak, MI · On-site

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 ...

Strive Health

Nurse Practitioner

Royal Oak, MI · On-site

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 ...

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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.

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

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Seasonal Hcc Risk Adjustment Coding jobs near you

Certified Risk Adjustment Coding Specialist

Trinity Health

Livonia, MI • On-site

Other

Medical, Dental, Vision, Retirement, PTO

Posted 2 days ago

New

Trinity Health rating

6.6

Company rating: 6.6 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

572nd of 898 rated healthcare providers

Job description

Employment Type:
Full timeShift:
Description:
CERTIFIED RISK ADJUSTMENT CODING SPECIALIST
Location: Trinity Health PACE Corp Michigan
Status: Full time Remote
Position Purpose:
The primary purpose of this position is to assign ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical records and providing education on documentation to support HCCs.
Position Details:
This is a fully remote position. Work hours will be 8 to 430 or 7 to 330 Eastern.
Training will take place in person in Livonia, MI for one week (expenses paid). Onsite training is required for position. Onsite training would take place during the 2nd week of employment.
What you will do:
  • Evaluate medical records to identify diagnoses and procedures and accurately assigns and sequences ICD and CPT codes. Abstracts and validates information. Seeks out validating information as needed.
  • Conduct documentation spot checks and respond to audit feedback.
  • Ensure timely, accurate client care documentation for billing.
  • Monitors and informs manager of records that are not completed timely. Monitors, investigates and takes appropriate action for records that are not coded, billed, or rejected.
  • Stay updated on coding guidelines and reimbursement requirements.
  • Maintains participant confidentiality and abides by HIPAA guidelines.
  • Assures site staff compliance with federal/state and accreditation regulations through record review, case conferencing and communication.
Minimum Qualifications:
  • High school diploma or equivalent required. 2 years of completed college coursework preferred.
  • Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA
  • Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year if hired.
  • Two-years of experience in a risk adjustment coding environment required.
  • Demonstrated the ability to verify and validate HCCs.
  • Demonstrated the knowledge and ability to work with providers on education and guidance.
  • Demonstrated knowledge of medical terminology, human anatomy and physiology, and diseases processes.
  • Strong communication, problem-solving, customer service, critical thinking, and organizational skills.
  • Comprehensive proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); Ability to use other software as required to perform the essential functions of the job.
  • Ability to prioritize workload.
  • Position may require occasional travel to home office in Livonia, MI or other supported locations.
Position Highlights and Benefits:
  • Comprehensive benefit including 1st Day medical coverage, dental, vision, paid time off, 403B and educational assistance.
  • Access to daily pay and employee referral incentives.
  • Supportive environment with a patient-centered focus.
  • Opportunities for professional development.

Ministry/Facility Information
Trinity Health PACE provides high-quality care to seniors in the communities we serve. Our interdisciplinary team offers comprehensive services, allowing seniors to remain independent at home.
We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity.
Apply now!
Min Pay Range: 24.00
Max Pay Range: 36.00
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. 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 any other status protected by federal, state, or local law.

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About Trinity Health

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Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US

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