Position Purpose The Director, Prospective Risk Adjustment Operations leads the organization ... Oversees all provider-facing prospective HCC coding accuracy programs. * Develops, deploys, and ...
Position Purpose The Director, Prospective Risk Adjustment Operations leads the organization ... Oversees all provider-facing prospective HCC coding accuracy programs. * Develops, deploys, and ...
Coding Analyst Sr.
Harvey, LA · On-site
AAPC Certified Risk Adjustment Coder (CRC) is highly preferred. * Knowledge of medical terminology and anatomy strongly preferred. Please be advised that Elevance Health only accepts resumes for ...
Coding Analyst Sr.
Harvey, LA · On-site
AAPC Certified Risk Adjustment Coder (CRC) is highly preferred. * Knowledge of medical terminology and anatomy strongly preferred. Please be advised that Elevance Health only accepts resumes for ...
Director of Reimbursement
New Orleans, LA · On-site
Expert understanding of CMS regulations, risk adjustment (HCC coding), and Medicaid rate-setting mechanisms. * Advanced proficiency in financial modeling, data analytics, and Electronic Health Record ...
New
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Director of Reimbursement
New Orleans, LA · On-site
Expert understanding of CMS regulations, risk adjustment (HCC coding), and Medicaid rate-setting mechanisms. * Advanced proficiency in financial modeling, data analytics, and Electronic Health Record ...
New
Expert understanding of CMS regulations, risk adjustment (HCC coding), and Medicaid rate-setting mechanisms. * Advanced proficiency in financial modeling, data analytics, and Electronic Health Record ...
New
Expert understanding of CMS regulations, risk adjustment (HCC coding), and Medicaid rate-setting mechanisms. * Advanced proficiency in financial modeling, data analytics, and Electronic Health Record ...
New
Director of Reimbursement
New Orleans, LA · On-site
Expert understanding of CMS regulations, risk adjustment (HCC coding), and Medicaid rate-setting mechanisms. * Advanced proficiency in financial modeling, data analytics, and Electronic Health Record ...
Director of Reimbursement
New Orleans, LA · On-site
Expert understanding of CMS regulations, risk adjustment (HCC coding), and Medicaid rate-setting mechanisms. * Advanced proficiency in financial modeling, data analytics, and Electronic Health Record ...
Senior Coding Educator
Winnsboro, LA · On-site
$26 - $29.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Winnsboro, LA · On-site
$26 - $29.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$24.75 - $28.25/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$24.75 - $28.25/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$27.75 - $31.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$27.75 - $31.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$26.75 - $30.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$26.75 - $30.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$22.50 - $25.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$22.50 - $25.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$23.25 - $26.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$23.25 - $26.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Deridder, LA · On-site
$25.75 - $29.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Deridder, LA · On-site
$25.75 - $29.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Gibsland, LA · On-site
$22.75 - $26/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Gibsland, LA · On-site
$22.75 - $26/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$19.25 - $22/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$19.25 - $22/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Ferriday, LA · On-site
$23.50 - $26.75/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Ferriday, LA · On-site
$23.50 - $26.75/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Natchitoches, LA · On-site
$24.25 - $27.75/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Natchitoches, LA · On-site
$24.25 - $27.75/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$23.25 - $26.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$23.25 - $26.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Greensburg, LA · On-site
$20.50 - $23.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Greensburg, LA · On-site
$20.50 - $23.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Harrisonburg, LA · On-site
$24.25 - $27.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
Harrisonburg, LA · On-site
$24.25 - $27.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$26 - $29.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
Senior Coding Educator
$26 - $29.50/hr
Responsible for creating and executing the risk adjustment strategy for each provider groups ... Familiar with coding guidelines (i.e. ICD-9/ICD-10) * Reside in AL, TN LA or MS * Analyzing Data to ...
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?
| Aspect | Trainee Hcc Risk Adjustment Coding | Hcc Risk Adjustment Coder |
|---|---|---|
| Certifications | None or entry-level certifications | Certified Professional Coder (CPC) or equivalent |
| Work Environment | Training programs, supervised settings | Independent coding in healthcare facilities |
| Job Responsibilities | Learning coding processes, assisting with documentation | Accurate 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.
What are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Louisiana? The most popular types of Hcc Risk Adjustment Coding jobs in Louisiana are:
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Director, Prospective Risk Adjustment Operations
Baton Rouge, LA • Remote
Full-time
Posted 17 days ago
Job description
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.
Residency in or relocation to Louisiana is preferred for all positions.
Position Purpose
The Director, Prospective Risk Adjustment Operations leads the organization's prospective risk adjustment accuracy strategy and execution across Medicare Advantage and ACA products. This role is accountable for the design, implementation, and optimization of provider-facing and member-facing programs that ensure complete, accurate, and compliant documentation of member health status at the point of care. The Director oversees Clinical Documentation Integrity (CDI), provider engagement, Annual Wellness Visit initiatives, in-home and telehealth assessment programs, and other prospective risk adjustment interventions designed to drive accurate HCC capture and improve risk adjustment outcomes.
How You Contribute to the Company's Mission in this Role
Strategic Leadership
Leads the development and execution of enterprise-wide prospective risk adjustment operational strategies.
Translates analytical insights into scalable operational programs that improve documentation accuracy, provider engagement, and member participation.
Establishes performance goals, operational metrics, and accountability measures to achieve enterprise risk adjustment objectives.
Provider-Facing Prospective Coding Accuracy Programs
Oversees all provider-facing prospective HCC coding accuracy programs.
Develops, deploys, and scales Clinical Documentation Integrity (CDI) programs focused on suspected and previously coded conditions, practice transformation initiatives, and payer-provider process integration.
Engages providers to improve documentation quality and coding accuracy through education, performance reporting, and consultative support.
Aligns provider incentive structures with coding accuracy objectives and broader quality improvement programs.
Member-Facing Coding Accuracy Programs
Leads initiatives designed to improve member participation in prospective risk adjustment activities.
Oversees integration of Annual Wellness Visit outreach efforts into existing member engagement programs.
Develops new outreach strategies targeting members at risk of non-engagement.
Oversees Comprehensive Health Evaluation programs, including in-home and telehealth health assessments.
Cross-Functional Collaboration
Collaborates with healthcare analytics, provider organizations, value-based care teams, population health, compliance, and clinical leadership to advance prospective risk adjustment goals.
Partners with internal stakeholders to integrate risk adjustment communications and interventions throughout the member lifecycle.
Builds and maintains relationships with vendors and strategic partners that support prospective coding accuracy initiatives.
Operational Excellence
Owns operational infrastructure, workflows, performance management processes, and vendor oversight necessary to achieve program objectives.
Monitors and drives performance related to prospective HCC recapture, provider coding accuracy, Annual Wellness Visit completion, in-home assessment completion, and provider engagement outcomes.
Ensures all programs operate in accordance with regulatory and compliance requirements.
Required Qualifications
Education
Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Nursing, Finance, or a related field required.
Master's degree preferred.
Experience
Seven (7) years of progressive leadership experience in risk adjustment, population health, provider engagement, healthcare operations, value-based care, or a related healthcare function.
Experience developing and leading provider-facing initiatives designed to improve documentation quality, coding accuracy, and operational performance.
Demonstrated experience leading large-scale operational programs and cross-functional teams.
Experience working with Medicare Advantage, ACA, risk adjustment methodologies, HCC coding, and healthcare reimbursement programs preferred.
Knowledge, Skills, and Abilities
Strong knowledge of prospective risk adjustment principles, HCC coding methodologies, and documentation integrity practices.
Understanding of provider engagement strategies, population health management, and value-based care models.
Ability to analyze complex operational and performance data and translate findings into actionable business strategies.
Strong communication, relationship management, and influencing skills.
Demonstrated ability to lead organizational change and drive measurable results through cross-functional collaboration.
Strong project management, process improvement, and vendor management skills.
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
All internal employees please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.
In support of our mission to improve the health and lives of Louisianians, we encourage the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
We perform background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, we are a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
About Louisiana Workforce Commission
Sourced by ZipRecruiter
The Louisiana Workforce Commission’s vision is to make Louisiana the best place in the country to get a job or grow a business, and our goal is to be the country's best workforce agency. Our mission is simple and straightforward – we put people to work. Today, the LWC is ideally positioned and structured to support and serve Louisiana’s employers, job seekers and workforce partners.
Industry
Public administration
Company size
11 - 50 Employees
Headquarters location
Baton Rouge, LA, US
Year founded
2008