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Senior Hcc Risk Adjustment Coder Jobs in Arizona

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Aledade

Clinical Risk Educator, Remote

Phoenix, AZ · On-site

... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...

Banner Health

RN Population Health

Phoenix, AZ

CORE FUNCTIONS 1. Serves as a subject matter expert in support of Risk Adjustment Factor (RAF ... coding requirements, HCCs, HEDIS quality ratings. 2. Establishes and promotes a collaborative ...

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Senior Hcc Risk Adjustment Coder information

What does a Senior HCC Risk Adjustment Coder do?

A Senior HCC Risk Adjustment Coder reviews medical records and assigns appropriate ICD-10 codes to ensure accurate risk adjustment for healthcare organizations. Their work supports proper reimbursement and compliance by identifying and coding Hierarchical Condition Categories (HCCs) based on clinical documentation. Senior coders typically have advanced knowledge of coding guidelines, risk adjustment models, and relevant regulations such as Medicare Advantage requirements. They may also audit coding work, provide training, and help implement best practices within their teams.

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

Senior HCC Risk Adjustment Coders often encounter challenges such as keeping up with frequent coding guideline updates, navigating complex electronic health record systems, and ensuring accurate documentation to support risk adjustment scores. To address these, staying current with industry training and certification requirements is essential, as is developing strong communication skills to collaborate effectively with providers and other coding professionals. Regular auditing and feedback can also help maintain high accuracy and compliance, contributing to both individual and team success.

What are the key skills and qualifications needed to thrive as a Senior HCC Risk Adjustment Coder, and why are they important?

To thrive as a Senior HCC Risk Adjustment Coder, you need in-depth knowledge of ICD-10-CM coding, risk adjustment methodologies, and a relevant credential such as CPC, CRC, or CCS. Familiarity with coding software, EHR systems, and risk adjustment analytics platforms is essential. Attention to detail, analytical thinking, and strong communication skills distinguish top performers in this role. These skills ensure accurate documentation and coding, directly impacting healthcare organizations' compliance and financial outcomes.
Senior Hcc Risk Adjustment Coder jobs near you
Certified Coder (Risk Adjustment Experience Required) - REMOTE

Certified Coder (Risk Adjustment Experience Required) - REMOTE

Molina Healthcare

Tucson, AZ • Remote

$19.84 - $38.69/hr

Full-time

Posted 8 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

143rd of 277 rated insurance

Job description

JOB DESCRIPTION Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials.
• Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately.
• Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff.
• Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment.
• Builds positive relationships between providers and the business by providing coding assistance as needed.
• Facilitates administrative duties such as planning, chart reviews scheduling, medical records procurement, provider training and education.
• Assists in coordination of management activities with other departments including finance, revenue analytics, claims, encounters and enterprise/plan medical directors.
• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies related to medical coding in the managed care industry.
Required Qualifications• At least 2 years medical coding experience, or equivalent combination of relevant education and experience.
• Certified Professional Coder (CPC).
• Certified Coding Specialist (CCS).
• Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge.
• Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Ability to effectively interface with staff, clinicians, and management.
• Excellent verbal and written communication skills.
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and all other customers.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Risk Adjustment Coder (CRC).
• Certified Professional Payer – Payer (CPC-P).
• Certified Coding Specialist – Physician Based (CCS-P).
• Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model.
• Background in supporting risk adjustment management activities and clinical informatics.
• Experience with risk adjustment data validation.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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