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Trainee Hcc Risk Adjustment Coding Jobs in Ohio (NOW HIRING)

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

CareSource

Applied AI Scientist III

Dayton, OH · On-site +1

... expertise and code reviews. Essential Functions: * Evaluate emerging technology in LLMs, NLP ... Work closely with interdisciplinary teams across IT, risk adjustment, program integrity, HEDIS ...

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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.
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:
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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:
Trainee Hcc Risk Adjustment Coding jobs near you
Infographic showing various Trainee Hcc Risk Adjustment Coding job openings in Ohio as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution.
PHYSICIAN ADVISOR

PHYSICIAN ADVISOR

Premier Health

Dayton, OH • On-site

Full-time

Posted 14 days ago

Job description

The Physician Advisor - CDI, Coding & Quality serves as a key clinical leader supporting Premier Health's goals to advance documentation accuracy, revenue integrity, and quality performance across the health system. This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams.
The Physician Advisor provides expert second-level reviews, leads provider education, and partners closely with the CDI Manager, Coding Manager and interdisciplinary teams to ensure that documentation accurately reflects the clinical complexity, severity of illness, and quality outcomes of Premier Health's patient population.
Key Responsibilities
1. Clinical Documentation Integrity (CDI) Leadership
• Provide secondary review of complex CDI and Coding queries escalated by the CDI and Coding teams.
• Review and resolve escalations involving Query disagreement, Clinical Validation, or incomplete response.
• Partner with the CDI Manager to establish standardized escalation criteria and ensure timely resolution of all high-impact queries.
• Conduct focused "second-look" reviews of no-CC/MCC or CC-only cases to identify missed documentation opportunities and support CMI improvement.
• Serve as a liaison between the CDI, Coding, and Physician teams to promote consistency in documentation practices.
2. Provider Engagement and Education
• Conduct one-on-one meetings with providers to review query metrics, patterns, and opportunities for improvement.
• Deliver targeted education sessions on documentation best practices, MCC/CC capture, and quality measure alignment.
• Participate in residency and faculty education (Internal Medicine, Family Practice, Trauma, Critical Care, etc.) including lectures and QIPS elective rotations on CDI and professional billing documentation.
• Partner with the CDI Manager and Quality leadership to develop and disseminate system-wide education tools and tip sheets.
3. CMI and Quality Improvement
• Analyze and communicate CMI trends by service line; support interventions to drive improvement aligned with Vizient benchmarks.
• Collaborate with Digital Health team to refine dashboards and enable data-driven improvement strategies.
• Participate in pre-claim mortality and risk adjustment reviews, focusing on REM score optimization and accurate capture of clinical risk variables.
• Support PSI/HAC reviews from a CDI perspective in partnership with Quality and CDI teams.
4. Interdisciplinary Collaboration
• Serve as a clinical resource to the CDI, Coding, and Quality departments on complex documentation and regulatory compliance questions.
• Partner with Digital Health to support AI-enabled CDI nudges, EHR workflow optimization, and system note-template refinement and creation for service lines.
• Contribute to system-wide initiatives related to mortality O/E, LOS O/E, and cost efficiency performance, Vizient facility ranking and Elix Hauser risk adjustment methodologies.
Performance Expectations
• Achieve a sizeable conversion rate on escalated CDI/Coding queries.
• Demonstrate measurable CMI improvement in targeted service lines.
• Support system improvement in key Vizient metrics (Mortality O/E, Cost O/E, LOS O/E).
• Maintain provider query agreement rate ≥80% and consistent educational engagement.
Qualifications
Education: Doctor of Medicine (MD) or Doctor of Osteopathy (DO) required.
• Licensure: Active Ohio medical license (or eligibility for licensure).
• Experience:
- Minimum 3 years of clinical practice experience.
- Prior involvement in CDI, and or quality improvement preferred 1-2 years' experience
- Strong working knowledge of ICD-10, MS-DRG/APR-DRG systems, and risk adjustment models Vizient, CMS, Elixhauser etc.
• Skills:
- Excellent communication and teaching skills.
- Ability to interpret clinical and coding guidelines with precision.
- Proficiency with EHR systems (Epic experience preferred).

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