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Trainee Hcc Risk Adjustment Coding Jobs in Texas

Value Based Coder II

Houston, TX

$18 - $23.75/hr

Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education ...

Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education ...

This role is critical to advancing the organization's risk adjustment performance by supporting accurate, timely, and sustainable identification of documentation and coding opportunities across the ...

$20 - $25/hr

... coding experience (cardiology, urology, dermatology, general surgery, pulmonology) • Strong knowledge of: o ICD-10-CM o CPT o HCPCS o NCCI edits o E/M 2021+ guidelines o HCC/RAF risk adjustment ...

$20 - $25/hr

... coding experience (cardiology, urology, dermatology, general surgery, pulmonology) • Strong knowledge of: o ICD-10-CM o CPT o HCPCS o NCCI edits o E/M 2021+ guidelines o HCC/RAF risk adjustment ...

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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.
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Value Based Coder II

$18 - $23.75/hr

Full-time

Posted 29 days ago


CommonSpirit Health rating

7.1

Company rating: 7.1 out of 10

Based on 521 frontline employees who took The Breakroom Quiz

374th of 886 rated healthcare providers


Job description

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.


The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement.

1. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding.
2. Advanced Documentation Improvement & Education: Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture. Develop and deliver effective education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture. Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles.
3. Compliance & Regulatory Insight: Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education efforts. Champion a culture of compliance by advocating for best practices and providing robust provider support to ensure CommonSpirit adheres to all federal and coding guidelines pertaining to HCC and risk adjustment. Safeguard medical records and preserve the confidentiality of personal health information through adherence to all relevant policies (release of medical record information, record retention, HIPAA privacy and security).
4. Process Improvement & Collaboration: Actively participate in network performance improvement initiatives, offering insights and solutions based on coding expertise. Collaborate with providers and office staff to address documentation deficiencies and coding gaps.


2+ years of experience in outpatient coding
2+ years focused on risk adjustment and HCC principles.

Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC codingguidelines and risk adjustment models.
Strong understanding of federal and state guidelines on all coding systems and sponsored programs.
Proficiency in developing and delivering educational content.
Effective interpersonal, communication, and presentation skills (both verbal and written).
Ability to manage multiple priorities and work independently.
Computer literacy in medical information systems, records management software, and encoder software.

Preferred/Desired Experience
4+ years of experience in outpatient coding,
3+ years focused on risk adjustment and HCC principles


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