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Trainee Hcc Risk Adjustment Coding Jobs in Colorado

Phpmcs

Physician - Primary Care - Denver

Denver, CO · On-site

$190 - $220/hr

PHPprime provides wrap-around services to help make our practice successful, including care coordination, practice transformation coaching, risk adjustment coding education, population health ...

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Trainee Hcc Risk Adjustment Coding information

How to get into risk adjustment coding?

To become a Trainee HCC Risk Adjustment Coder, individuals typically need a high school diploma or equivalent, followed by completing specialized training or certification in risk adjustment coding, such as the AHIMA Certified Risk Adjustment Coder (CRC) credential. Gaining proficiency in medical coding, understanding of diagnosis coding systems like ICD-10, and familiarity with healthcare data are essential for entry-level roles in this field.

Is HCC coding a good career?

HCC risk adjustment coding is a growing field within healthcare, focusing on accurately documenting patient health conditions for insurance reimbursement and risk management. It requires knowledge of medical coding, attention to detail, and often certification, making it a stable career with demand across healthcare organizations. Many professionals find it a rewarding career due to its specialized nature and opportunities for remote work.

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

Trainee HCC Risk Adjustment Coders often encounter challenges such as interpreting complex medical documentation, staying up-to-date with changing coding guidelines, and accurately assigning codes that reflect patients' true risk profiles. Overcoming these challenges involves continuous learning, seeking mentorship from experienced coders, and utilizing resources like coding manuals and online forums. Collaborating with clinical staff and participating in regular training sessions can also enhance accuracy and confidence in the coding process.

What is the difference between Trainee Hcc Risk Adjustment Coding vs Hcc Risk Adjustment Coder?

AspectTrainee Hcc Risk Adjustment CodingHcc Risk Adjustment Coder
CertificationsNone or entry-level certificationsCertified Professional Coder (CPC) or equivalent
Work EnvironmentTraining programs, supervised settingsIndependent coding in healthcare facilities
Job ResponsibilitiesLearning coding processes, assisting with documentationAccurate coding, claim submission, compliance

The main difference is that Trainee Hcc Risk Adjustment Coders are in training or entry-level roles, focusing on learning and assisting, while Hcc Risk Adjustment Coders are experienced professionals responsible for independent coding and compliance tasks.

What is a Trainee HCC Risk Adjustment Coder?

A Trainee HCC Risk Adjustment Coder is an entry-level professional who is learning how to review and assign medical codes for diagnoses in patient records, specifically for the Hierarchical Condition Category (HCC) risk adjustment model. This role involves training in medical coding standards, healthcare regulations, and compliance requirements to ensure accurate coding for insurance and Medicare/Medicaid reimbursement. Trainees typically work under supervision and are expected to develop a strong understanding of ICD-10-CM coding, clinical documentation improvement, and the principles of risk adjustment. The position is ideal for those starting a career in medical coding and offers a pathway to becoming a certified HCC coder.

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

To thrive as a Trainee HCC Risk Adjustment Coder, you need a foundational understanding of medical coding, anatomy, and healthcare terminology, often supported by a relevant certification or coursework. Familiarity with ICD-10-CM coding systems, electronic health records (EHRs), and risk adjustment software is typically required. Strong attention to detail, analytical thinking, and effective communication are important soft skills in this role. These skills ensure accurate coding, which directly impacts proper reimbursement, compliance, and the quality of patient care data.

How much does a certified risk adjustment coder make?

A certified risk adjustment coder typically earns between $50,000 and $80,000 annually, depending on experience, certification level, and geographic location. Entry-level positions may start lower, while experienced coders with advanced certifications can earn higher salaries, especially in healthcare settings that emphasize accurate risk adjustment coding.

How much do HCC coders make in the US?

HCC risk adjustment coders typically earn between $50,000 and $80,000 annually in the US, depending on experience, certification, and location. Entry-level positions may start lower, while experienced coders with certifications like CPC or CCS can earn higher salaries, especially in healthcare hubs or with specialized skills.
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Trainee Hcc Risk Adjustment Coding jobs near you
Sr. Manager, Risk Adjustment Analytics

Sr. Manager, Risk Adjustment Analytics

Staffingine LLC

Denver, CO • On-site

Full-time

Re-posted 5 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