... for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and ...
... for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and ...
... responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and ...
... for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and ...
... responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding ... Reviewing the ambulatory records for the appropriate risk adjustment components * Identify ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
Revenue Cycle Coordinator
Cincinnati, OH · On-site
The Revenue Cycle Coordinator is responsible for accurate coding, charge review, risk-adjustment ... HCC) and communicate documentation needs to providers. • Conduct ongoing coding audits and ...
Revenue Cycle Coordinator
Cincinnati, OH · On-site
The Revenue Cycle Coordinator is responsible for accurate coding, charge review, risk-adjustment ... HCC) and communicate documentation needs to providers. • Conduct ongoing coding audits and ...
Remote - HCC Medical Coder
$18.25 - $24.50/hr
The Hierarchical Condition Category (HCC) Medical Coder is responsible for assigning ICD-10-CM diagnosis codes and/or HCC's as appropriate to reflect risk adjustment and abstracts pertinent ...
Remote - HCC Medical Coder
$18.25 - $24.50/hr
The Hierarchical Condition Category (HCC) Medical Coder is responsible for assigning ICD-10-CM diagnosis codes and/or HCC's as appropriate to reflect risk adjustment and abstracts pertinent ...
Consulting Actuary - ACA Risk Adjustment
$143.62K - $229.79K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Consulting Actuary - ACA Risk Adjustment
$143.62K - $229.79K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... with Risk Adjustment. Provide overall coding expertise as well as administrative and technical ... Monitor HCC Coding Accuracy at various levels of detail (e.g., by state, by product, by demographic ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... with Risk Adjustment. Provide overall coding expertise as well as administrative and technical ... Monitor HCC Coding Accuracy at various levels of detail (e.g., by state, by product, by demographic ...
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
HIM Coder - Professional
Portsmouth, OH · On-site
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
HIM Coder - Professional
Portsmouth, OH · On-site
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Chronic Kidney Disease Community Based Provider (CKD CBP) Dayton
Dayton, OH · On-site
$99.60K - $136.10K/yr
Familiarity with value-based care models, risk adjustment, and clinical documentation standards (HCC capture, MEAT/DSP criteria) preferred. * Behavioral health and substance use disorder experience ...
Chronic Kidney Disease Community Based Provider (CKD CBP) Dayton
Dayton, OH · On-site
$99.60K - $136.10K/yr
Familiarity with value-based care models, risk adjustment, and clinical documentation standards (HCC capture, MEAT/DSP criteria) preferred. * Behavioral health and substance use disorder experience ...
Chronic Kidney Disease Community Based Provider (CKD CBP) Cleveland
Cleveland, OH · On-site
$99.30K - $135.60K/yr
Familiarity with value-based care models, risk adjustment, and clinical documentation standards (HCC capture, MEAT/DSP criteria) preferred. * Behavioral health and substance use disorder experience ...
Chronic Kidney Disease Community Based Provider (CKD CBP) Cleveland
Cleveland, OH · On-site
$99.30K - $135.60K/yr
Familiarity with value-based care models, risk adjustment, and clinical documentation standards (HCC capture, MEAT/DSP criteria) preferred. * Behavioral health and substance use disorder experience ...
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
Applied Analytics Intern
New Albany, OH · On-site
$25/hr
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
Quick apply
Applied Analytics Intern
New Albany, OH · On-site
$25/hr
... coding, abstraction, reporting, and submissions. Leveraging proprietary technology, robust data ... Reveleer partners with health plans to power value-based care and risk adjustment programs through ...
... HCC) and communicate documentation needs to providers. • Conduct ongoing coding audits and ... coding accuracy, documentation quality, risk-adjustment capture, and compliance. • Ensure ...
... HCC) and communicate documentation needs to providers. • Conduct ongoing coding audits and ... coding accuracy, documentation quality, risk-adjustment capture, and compliance. • Ensure ...
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?
| 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 are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Ohio? The most popular types of Hcc Risk Adjustment Coding jobs in Ohio are:
What are popular job titles related to Trainee Hcc Risk Adjustment Coding jobs in Ohio? For Trainee Hcc Risk Adjustment Coding jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Trainee Hcc Risk Adjustment Coding jobs in Ohio look for? The top searched job categories for Trainee Hcc Risk Adjustment Coding jobs in Ohio are:
What cities in Ohio are hiring for Trainee Hcc Risk Adjustment Coding jobs? Cities in Ohio with the most Trainee Hcc Risk Adjustment Coding job openings:
Kettering Health rating
7.2
Based on 180 frontline employees who took The Breakroom Quiz
326th of 864 rated healthcare providers
Job description
Physician Office | Kettering | Full-Time | First Shift
Responsibilities & Requirements
This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation.
KPN Pro Fee Coding Specialist
Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
- Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
- Reviewing the ambulatory records for the appropriate risk adjustment components
- Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes
- Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
- Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy]
- Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
- Corresponds with providers on pending claims to facilitate resolution
- Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
- Communicate appropriately with providers, leaders, and staff
- Researches and resolves concerns timely
The Risk Adjustment Coder is responsible for coding and abstracting all outpatient patient records using ICD-10-CM and CPT/HCPCS coding rules, federal guideline and KMCN guidelines. Additionally, the Risk Adjustment Coder supports hospital’s accounts receivable goals through timely processing of records and physician record completion activities. Impacts delivery of quality patient care and enhanced clinical decision-making process. Supports clinical outcomes measurement and assessment process for service lines. Completes assigned duties and other related tasks. The list is not inclusive, Performs other duties as assigned.
The Risk Adjustment Coder will supplement the educational offerings of the MSO by providing right-time feedback to providers when documenting or coding the risk adjustment on patient records. The Risk Adjustment Coder will contribute to overarching educational efforts of the MSO regarding Risk Adjustment. The Risk Adjustment Coder will offer summarized content, feedback from providers, key barriers or success efforts to executive leaders to assist in the overall risk adjustment of the population.
The Risk Adjustment Coder will spend some in-person time with providers to foster a relationship and encourage dialogue with risk adjustment to improve overall outcomes. The Risk Adjustment Coder will develop a collegial relationship with the Clinical Documentation Specialist RN (CDS) to partner on the overarching risk adjustment of the population.
Educational Requirements:
High School Diploma or equivalent
RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification
Prior experience in professional fee coding/billing
CRC required within 1 year of hire
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.
What Kettering Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom