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Senior Hcc Risk Adjustment Coder Jobs in Florida

Cano Health

Risk Adjustment Coder

Jupiter, FL · On-site

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... Work HCC suspect reports * Accurately code and submit encounters on a timely basis * Researching ...

Msmc

Certified Risk Adjustment Coder

Hialeah, FL

$20.50 - $27.75/hr

Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... risk adjustment coding * Demonstrates understanding of risk adjustment payment models * Uses ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

BHC ISC

PBO Risk Adjustment Coding

Fort Lauderdale, FL · On-site

... Risk HRA/HCC Assessment forms Medicare Advantage plans suspect HCC condition forms prior to ... Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) Visit us online at www.

Centrum Health

Risk Adjustment Analyst

Doral, FL

Using SQL code, mine data on medical spend, clinical data and population health data and derive ... Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP ...

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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 Florida? The most popular types of Hcc Risk Adjustment Coder jobs in Florida are:
What cities in Florida are hiring for Senior Hcc Risk Adjustment Coder jobs? Cities in Florida with the most Senior Hcc Risk Adjustment Coder job openings:
Senior Hcc Risk Adjustment Coder jobs near you
Risk Adjustment Coder

Risk Adjustment Coder

Cano Health

Jupiter, FL • On-site

Full-time

This job post has expired 2 days ago. Applications are no longer accepted.

Cano Health rating

7.6

Company rating: 7.6 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

It's rewarding to be on a team of people that truly believe in making an impact!
We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.
Job Summary
The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.
Duties & Responsibilities
Essential Duties & Responsibilities
  • Review medical record information to identify all appropriate coding based on CMS HCC categories
  • Prepare the medical charts and track patient information via Excel spreadsheets.
  • Complete appropriate paperwork/documentation/system entry regarding claim/encounter information
  • Provide coding support, education and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards
  • Provide real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS and STARS
  • Monitor coding changes to ensure that most current information is available
  • Work HCC suspect reports
  • Accurately code and submit encounters on a timely basis
  • Researching and addressing code questions for multiple provider offices as directed
  • Update the Director on the status on a weekly basis
  • Notifies Patient Experience Manager if annual wellness visits for patients have not been scheduled.
  • Travel to offices as necessary to complete on-site chart reviews
  • Performs post-audits on assigned offices and notifies office contact when codes are not addressed for provider review.
  • Support and participate in process and quality improvement initiatives.
  • Assists with billing claims as assigned.

Additional Duties & Responsibilities
  • Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Due to the nature of this position, it is understood that coding requirements are expected to change; therefore, participation in affiliated classes and individual efforts to maintain current knowledge of these changes is required.

Education & Experience
  • Two (2) years prior medical coding experience
  • Proficient in Microsoft Word and Excel
  • Strong organization and process management skills
  • Strong collaboration and relationship building skills
  • High attention to detail
  • Excellent written and verbal communication skills
  • Ability to learn new tasks and concepts
  • CPC, CPC-A or CCS-P, CRC Coding Certification

Knowledge, Skills & Proficiencies
  • Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments and takes responsibility for the impact of one's actions.
  • Pursues Excellence: Seeks out learning, strives to develop and expand personally, and continuously helps others upgrade their capability to contribute to the managed care plan.
  • Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces changes and constructively resolves barriers and constraints.
  • Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that places emphasis on the success of the medical centers and insurance companies.

Job Requirements
Physical Requirements
This position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Tools & Equipment Used
Computer and peripherals, standard and customized software applications and tools, and usual office equipment.
Disclaimer
The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
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