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Senior Hcc Risk Adjustment Coder Jobs in Delaware

... HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment ...

Become a part of our caring community The Risk Adjustment Coding Analyst provides operational ... CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness ...

$108/hr

... risk adjustment coding education, population health management, data and analytics, specialist ... senior populations. Alpine brings this same level of passion to employee engagement, career ...

... risk adjustment coding education, population health management, data and analytics, specialist ... senior populations. Alpine brings this same level of passion to employee engagement, career ...

Patient Care Advocate

Newark, DE · On-site

$17.50 - $22.50/hr

... areas of Quality, Risk Adjustment, Operations (claims and encounters). Schedules doctor ... and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements. • Assesses provider ...

New

This includes executing key data integrity controls, reconciliations, adjustments, and analytics ... Prepare key performance indicators or metrics and present them to senior management. Required ...

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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 the key skills and qualifications needed to thrive as a Senior HCC Risk Adjustment Coder?

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 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 cities in Delaware are hiring for Senior Hcc Risk Adjustment Coder jobs?

Cities in Delaware with the most Senior Hcc Risk Adjustment Coder job openings:

Auditor, HCC Risk Adjustment Coding

Dover, DE • On-site

Datavant
Software Development • 51 - 200 employees

$29 - $32/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago


Datavant rating

7.1

Company rating: 7.1 out of 10

Based on 103 frontline employees who took The Breakroom Quiz


Job description

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.

By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.

What We’re Looking For:

As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health status and confirming the accuracy of said work.

What You Will Do:

  • Audit coded charts assigned by quality supervisor per the client guidelines

  • Ability to move from different sets of client guidelines with minimal difficulty

  • Maintain a 95% quality average at a diagnosis level

  • Answer rebuttals entered on the auditor by coders and or auditors

  • Participate in weekly coding project review meetings

  • Any other tasks asked by quality supervisor

What You Need to Succeed:

  • 2 years' HCC Coding experience

  • 2 years' HCC Auditing experience

  • Extensive knowledge of ICD -10

  • High school diploma or GED equivalent required

  • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)

  • A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease processes

  • Ability to work in a fast-paced production environment while maintaining high quality

  • Must be able to follow instructions, meet deadlines and work independently

  • Ability to be flexible in work environment

  • Excellent written and verbal communication skills, ability to work in a remote environment and time management skills

  • Working knowledge of the business use of computer hardware and software to ensure effectiveness and quality of the processing and security of the data

What We Offer:

  • Comprehensive health, dental, and vision insurance

  • Paid time off (PTO) plan

  • Retirement savings plan

  • Flexible work arrangements

  • Opportunities for career growth and development

  • Employee wellness programs

We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that rewards our employees for transforming health care through creating industry-defining data logistics products and services.

The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job.

The estimated total cash compensation range for this role is:

$29—$32 USD

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

This job is not eligible for employment sponsorship.

Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (https://www.datavant.com/eeo-commitment-statement) . Know Your Rights (https://www.eeoc.gov/know-your-rights-workplace-discrimination-illegal) , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren’t even able to see whether you’ve responded.) Responding is entirely optional and will not affect your application or hiring process in any way.

Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (https://peopleteam.datavant.com/portal/en/newticket?departmentId=248697000248790029&layoutId=248697000248795462) by selecting the ‘Interview Accommodation Request’ category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (https://app.tango.us/app/workflow/Greenhouse--Locating-Requisition-ID-2c7d618c8a8a423da4330ff12330695e) . Requests for reasonable accommodations will be reviewed on a case-by-case basis.

For more information about how we collect and use your data, please review our Privacy Policy (https://www.datavant.com/privacy-policy) .


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