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Senior Hcc Risk Adjustment Coder Jobs in Colorado

DaVita, Inc.

Clinical Support Auditor (IKC)

Denver, CO · On-site +1

$35.75 - $48/hr

Experience in ICD-10 coding and documentation requirements and risk adjustment. * Knowledge of compliant query writing/process. * Ability to perform a comprehensive chart review of 20-30 medical ...

DaVita, Inc.

Clinical Support Auditor (IKC)

Denver, CO · On-site +1

$35.75 - $48/hr

Experience in ICD-10 coding and documentation requirements and risk adjustment. * Knowledge of compliant query writing/process. * Ability to perform a comprehensive chart review of 20-30 medical ...

DaVita, Inc.

Clinical Support Auditor (IKC)

Denver, CO · On-site +1

$35.75 - $48/hr

Experience in ICD-10 coding and documentation requirements and risk adjustment. * Knowledge of compliant query writing/process. * Ability to perform a comprehensive chart review of 20-30 medical ...

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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.
What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Colorado? The most popular types of Hcc Risk Adjustment Coder jobs in Colorado are:
What cities in Colorado are hiring for Senior Hcc Risk Adjustment Coder jobs? Cities in Colorado with the most Senior Hcc Risk Adjustment Coder job openings:
Senior Hcc Risk Adjustment Coder jobs near you
Sr. Manager, Risk Adjustment Analytics

Sr. Manager, Risk Adjustment Analytics

Staffingine LLC

Denver, CO • On-site

Full-time

Posted 13 days ago

Job description

Job Title: Sr Manager, Risk Adjustment Analytics 
Job Location: Denver, CO 
Job Type: Full Time 

Job Description:  

  • Provide strategic leadership and management for the IKC Risk Adjustment Accuracy 

  • Create and maintain leadership reports on IKC revenue financials and estimating impact IKC initiatives had on Medical Loss Ratio (MLR) 

  • Write SQL queries against data warehouses containing clinical operations and medical claims data to support analytic requests and deliver insights to various stakeholders 

  • Monitor evolving regulations and policies to ensure all processes and reporting meet compliance requirements 

  • Partner with clinical, financial, operational, legal, compliance, and IT teams to improve risk adjustment accuracy 

  • Serve as a subject matter expert on CMS risk adjustment for the enterprise and stay current on the latest industry trends 

  • Other duties as assigned 

Required Experience: 

  • 3 or more years’ professional experience with healthcare data, specifically medical claims and/or encounter data using SQL 

  • 3 or more years’ experience in healthcare financial management, healthcare consulting, medical economics, population health, and/or similar experience  

  • At least a year’s experience in creation, implementation, and impact estimation of prospective and retrospective risk adjustment initiatives, including CMS RAPS/Encounter data submissions 

  • Experience developing and managing direct reports 

Skills and knowledge needed to succeed in this role: 

  • Expert level knowledge of CMS-HCC models V24 and V28, claims data lifecycle, submission systems, regulation, compliance, and audits related to risk adjustment 

  • Strong understanding of healthcare economics, population health, and value based care 

  • Ability to work collaboratively in a cross functional team environment and communicate effectively with teammates at all levels in an organization 

  • Comfortable presenting complex analysis and insights to executive audience 

  • Intellectual curiosity, strategic thinking and strong project management skills 

  • Comfort with ambiguous, ever-changing situations 

  • Strong entrepreneurial mindset with the motivation to continuously improve the status quo and drive this independently 

Must-haves 

  • Experience developing and managing direct reports Expert level knowledge of CMS-HCC models V24 and V28, claims data lifecycle, submission systems, regulation, compliance, and audits related to risk adjustment Strong understanding of healthcare economics, population health, and value based care Ability to work collaboratively in a cross functional team environment and communicate effectively with teammates at all levels in an organization Comfortable presenting complex analysis and insights to executive audience Intellectual curiosity, strategic thinking and strong project management skills Comfort with ambiguous, ever-changing situations Strong entrepreneurial mindset with the motivation to continuously improve the status quo and drive this independently