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Trainee Hcc Risk Adjustment Coding Jobs in Georgia

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Urrly

Telehealth Nurse Practitioner

Atlanta, GA · Remote

$600 - $720/day

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, preventive needs * Document visits using ICD-10 and CPT II ...

LCMC Health

... quality, risk adjustment, and reimbursement. * Oversee the physician query process, ensuring ... Inpatient Coding Management: * Oversee the inpatient coding team, ensuring accurate and timely ...

Humana

Medical Coder

Valdosta, GA · On-site +1

$16 - $21.50/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Milledgeville, GA · On-site +1

$17 - $22.75/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Lavonia, GA · On-site +1

$16.50 - $22/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Macon, GA · On-site +1

$18 - $24/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Valdosta, GA · On-site +1

$16 - $21.50/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Marietta, GA · On-site +1

$17.75 - $23.75/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Monroe, GA · On-site +1

$17.25 - $23.25/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Monroe, GA · On-site +1

$17.25 - $23.25/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Lithonia, GA · On-site +1

$17 - $22.75/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Monroe, GA · On-site +1

$17.25 - $23.25/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Macon, GA · On-site +1

$18 - $24/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder

Macon, GA · On-site +1

$18 - $24/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

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Trainee Hcc Risk Adjustment Coding information

Can I get a job as a medical coder with no experience?

Entry-level medical coding positions, including trainee HCC risk adjustment coding roles, often do not require prior experience but do require knowledge of medical terminology, coding systems like ICD-10, and attention to detail. Completing a coding certification or training program can improve job prospects, and some employers offer on-the-job training for beginners.

Is HCC coding a good career?

HCC coding for risk adjustment is a growing field in healthcare, offering stable employment opportunities and the potential for certification as a Certified Professional Coder (CPC) or similar credential. It requires attention to detail, knowledge of medical terminology, and familiarity with coding software, making it a viable career path for those interested in healthcare administration and medical billing.

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 to become a risk adjustment coder?

To become a risk adjustment coder, typically one needs a coding certification such as CPC or CCS, along with knowledge of medical coding and healthcare documentation. Training programs or courses in risk adjustment coding are often recommended, and experience with coding tools and electronic health records can enhance job prospects.

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.
What are popular job titles related to Trainee Hcc Risk Adjustment Coding jobs in Georgia? For Trainee Hcc Risk Adjustment Coding jobs in Georgia, the most frequently searched job titles are:
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Trainee Hcc Risk Adjustment Coding jobs near you
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Atlanta, GA • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

228th of 261 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • Certified professional coder (CPC)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.