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Trainee Hcc Risk Adjustment Coding Jobs in Georgia

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 ...

Humana

Clinical Coding Educator

Valdosta, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Macon, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Lavonia, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Milledgeville, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Macon, GA · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Monroe, GA · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Monroe, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Marietta, GA · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Valdosta, GA · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Valdosta, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Marietta, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Lawrenceville, GA · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

Humana

Clinical Coding Educator

Milledgeville, GA · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and ...

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Trainee Hcc Risk Adjustment Coding information

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.

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 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 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 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:
What job categories do people searching Trainee Hcc Risk Adjustment Coding jobs in Georgia look for? The top searched job categories for Trainee Hcc Risk Adjustment Coding jobs in Georgia are:
What cities in Georgia are hiring for Trainee Hcc Risk Adjustment Coding jobs? Cities in Georgia with the most Trainee Hcc Risk Adjustment Coding job openings:
Trainee Hcc Risk Adjustment Coding jobs near you
Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only

Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only

Pantar Solutions inc

Atlanta, GA • On-site

Contractor

Posted 24 days ago

Job description

We are an Information Technology and Business Consulting firm specializing in Project-based Solutions and Professional Staffing Services. Please have a look at below position which is with our Client and let me know your interest ASAP. I would really appreciate if you could send me your MOST RECENT UPDATED RESUME: 

Title: Business Analyst – Risk Adjustment (Payor)

Location: Richmond or Atlanta  – Hybrid role

Long Term Contract || 1099 only || Need USC or GC only

Need strong Business Analyst – Risk Adjustment (Payor) with  risk adjustment analytics in a healthcare payer environment (Medicare Advantage, ACA (HIX/Exchange), or Medicaid), SQL, Excel, data visualization tools (Tableau/Power BI/SAS), healthcare data formats (claims, encounters, EMR, lab, and eligibility), regulatory processes (CMS, HHS, EDGE server, RADV/IVA audits), HCC coding models (CMS-HCC, HHS-HCC), ICD-10 codes, and claims data Exp.

Consultant LinkedIn profile must have been created before 2018/2019

Need 8-10+yrs of IT Exp. Profiles

Job Summary:Client is seeking a highly analytical and motivated Business Analyst – Risk Adjustment to support risk adjustment operations and data analytics initiatives. This role is critical in helping ensure accurate and compliant capture of risk adjustment data for government-sponsored programs such as Medicare Advantage and ACA (HIX/Exchange). The candidate will play a key role in translating business needs into technical solutions, driving insights, and enabling optimized risk scoring strategies.
Key Responsibilities:

  • Analyze and interpret risk adjustment data (claims, encounters, chart reviews, HCCs) to identify trends, data quality issues, and improvement opportunities.

  • Collaborate with stakeholders across actuarial, clinical coding, IT, and compliance teams to support risk score accuracy.

  • Translate regulatory and business requirements into user stories or functional specifications for data/reporting solutions.

  • Support CMS/HHS risk adjustment submission processes including EDGE server management and encounter reconciliation.

  • Assist in development and enhancement of dashboards/reports for risk score monitoring, suspecting models, and provider performance.

  • Monitor and interpret changes in CMS/HHS risk adjustment guidelines and apply to internal business processes.

  • Participate in audit support (e.g., RADV, IVA) and validation of risk adjustment data submissions.

  • Act as liaison between technical teams and business stakeholders to ensure delivery of actionable and scalable solutions.

Qualifications:

  • Bachelor's degree in Healthcare Administration, Business, Analytics, or related field (Master’s preferred).

  • 8+ years of experience in risk adjustment analytics in a healthcare payer environment (Medicare Advantage, Medicaid, or ACA).

  • Strong knowledge of HCC models (CMS-HCC, HHS-HCC), ICD-10 coding, and risk adjustment methodologies.

  • Experience with healthcare data formats: claims, encounters, EMR, lab, and eligibility.

  • Proficiency in SQL and Excel; experience with BI tools like Power BI, Tableau, or SAS preferred.

  • Familiarity with regulatory processes (CMS, HHS, EDGE server, RADV/IVA audits).

Preferred Skills:

  • Knowledge of data and reporting tools, including Cognos or Watson Health platforms.

  • Experience in Agile environments; ability to write and manage JIRA user stories and tasks.

  • Strong communication and stakeholder engagement skills across technical and business teams.

 
Thanks & Regards,
 
Babu