ZipRecruiter

Log In

1

Senior Hcc Risk Adjustment Coder Jobs in Massachusetts

Valley Medical Group

Quality Specialist LPN

Greenfield, MA · On-site

$26.21 - $37.33/hr

HCC coding and risk adjustment review and analysis: review patients for targeted diagnosis gaps and update the EMR to reflect appropriate HCC diagnosis, and perform chart prep for the upcoming ...

Jj

Dir, HCC -Joints, Dig./Comm Ex

Raynham, MA · On-site

Serves as a thought partner to senior leaders, advising on complex business initiatives ... Familiarity with industry codes such asAdvaMed. Other * Language: English (required). * Travel: Up ...

Victory Capital

Senior Investment Risk Analyst

Boston, MA · On-site

$103K - $121K/yr

Senior Investment Risk Analyst San Antonio, TX or Boston, MA About Victory Capital: Victory Capital ... Willingness to learn coding (Python, R, VBA), with a focus on using APIs and data frames (Pandas ...

WSP

Senior Risk Manager

Boston, MA · On-site

WSP is currently initiating a search for a Senior Risk Manager in Boston, MA. Your Impact * Provide ... to WSP's Code of Conduct and related policies and procedures Preferred Qualifications:

WSP

Senior Risk Manager

Boston, MA · On-site

WSP is currently initiating a search for a Senior Risk Manager in Boston, MA. Your Impact * Provide ... to WSP's Code of Conduct and related policies and procedures Preferred Qualifications:

previous pagenext page

Showing results 21-40

All JobsHcc Risk Adjustment Coder JobsSenior Hcc Risk Adjustment Coder JobsSenior Hcc Risk Adjustment Coder Jobs in Massachusetts

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?

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

Quality Specialist LPN

Valley Medical Group

Greenfield, MA • On-site

$26.21 - $37.33/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Job description

Thank you for expressing your interest in pursuing a career with Valley Medical Group. We are a provider-owned, multi-specialty group. We proudly serve a diverse community of over 55,000 patients at four locations throughout the Pioneer Valley.

Valley Medical Group is looking for a Quality Specialist Licensed Practical Nurse to join our Family Practice team and work in our Greenfield Health Center. If you are looking for a dynamic environment, this is your opportunity!

NO NIGHTS! NO HOLIDAYS!

Position: Quality Specialist LPN

Location: Greenfield, MA

Hours: 40 hours, Monday-Friday generally between 7:30am and 4:00pm. Hours may vary depending on department needs. Exact schedule to be discussed at time of interview.

As a Quality Specialist LPN, you will be assigned projects and roles that contribute to the quality program, provide chart audit for risk adjustment projects, provide review and data entry into EMR for the accurate documentation of quality measures and preventative services, review and maintain filing and follow up for patient experience, complaint and incident reporting program as well as targeted projects to provide guidance to providers for appropriate diagnostic coding for risk adjustment that represents each patient’s level of chronic illness.

Job Responsibilities:

  • HCC coding and risk adjustment review and analysis: review patients for targeted diagnosis gaps and update the EMR to reflect appropriate HCC diagnosis, and perform chart prep for the upcoming appointment.
  • Review/abstract information from transferred medical records to update EMR quality measures and preventative services for new patient charts
  • Coordinate transition of care follow up phone calls with case management programs. Perform follow up phone calls, TCMS documentation for all appropriate patients not managed by risk contract case management staff. Update medication lists and problem lists as appropriate, schedule TCMS or Hospital/ER/SNF follow up appointments with PCP.
  • Liaison with health plan quality and HCC programs, updating HCC and preventative services in the health plan software platform to meet metrics for performance.
  • Review and file Incident and complaint forms. Follow up with appropriate managers and supervisors for outstanding or incomplete forms.
  • Review and manage patient experience data, initiate the patient complaint and incident review process for any comments provided less than 70% willingness to recommend, or comments that constitute a patient complaint regarding customer service or care.
  • Perform chart audit and data abstraction as needed for health plan risk contracts
  • Collaborate with other departments and key personnel including the Quality Physician, Quality Director, Health Information Coordinator, case management staff and clinical supervisors.
  • Other Duties as assigned: Quality LPNs perform special projects as needed that include research and review of EMR data.

Required Qualifications:

  • Current Massachusetts LPN License (or able to obtain licensure in MA)
  • Graduate of an accredited school of nursing (Associates or Bachelors)
  • Knowledge of chronic diseases, medications, disease management guidelines, medical terminology, ICD-10 coding, and knowledge of Hierarchal Condition Categories.
  • Minimum of 2 years outpatient medical experience
  • Current CPR certification
  • Strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly with excellent accuracy and attention to detail


Additional Preferred Qualifications:

  • Athena experience a plus


If you do not meet all of the preferred qualifications, we strongly encourage you to apply and/ or inquire. We often have multiple open positions and could consider you for another opportunity with our organization.

Valley Medical Group offers:

  • Medical, Dental & Vision Plans
  • 401(k) Plan with Company Match
  • Health Savings Account & Flexible Spending Account
  • Generous Paid Time Off
  • 7 Paid Holidays
  • Company-Paid Long-Term Disability Insurance
  • Company-Paid Life Insurance
  • Voluntary Life, Accident and Critical Illness Insurance Options
  • Company Wellness Program
  • Employee Assistance Program
  • Free On-Site Parking


We Value Employee Engagement and Inclusive Practices

Valley Medical Group (VMG) seeks to recruit, develop, and retain the most qualified workforce from a diverse candidate pool. We strive for every VMG staff person and provider to feel valued and be treated fairly, respectfully, and with dignity. We expect our employees to conduct themselves in a professional manner that promotes equal opportunity and prohibits unlawful discriminatory practices, including bias and harassment.

Fostering inclusion and belonging among our employees is critical to our success in providing high-quality patient care rooted in evidence-based practices and health equity. We have several initiatives that prioritize the employee experience, from an annual assessment of employee engagement to staff recognition events, various feedback mechanisms, and committees that promote an inclusive workplace.