San Antonio, TX · Remote
$22.10 - $38.25/hr
... HCC) ratio goals and risk adjustment improvement initiatives. The auditor prepares customized ... Coding certification (such as CPC, CRC, or CCS) is preferred, or candidates must demonstrate a ...
San Antonio, TX · Remote
$22.10 - $38.25/hr
... HCC) ratio goals and risk adjustment improvement initiatives. The auditor prepares customized ... Coding certification (such as CPC, CRC, or CCS) is preferred, or candidates must demonstrate a ...
Ensure compliance with ICD-10-CM, HCC guidelines, and CMS risk adjustment methodologies * Oversee quality outcomes from chart reviews and coding audits * Identify documentation gaps and implement ...
Ensure compliance with ICD-10-CM, HCC guidelines, and CMS risk adjustment methodologies * Oversee quality outcomes from chart reviews and coding audits * Identify documentation gaps and implement ...
Houston, TX · On-site
$21.50 - $29.25/hr
... ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key ... Risk Adjustment / HCC knowledge required * Managed Care experience preferred
Houston, TX · On-site
$21.50 - $29.25/hr
... ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key ... Risk Adjustment / HCC knowledge required * Managed Care experience preferred
Ensure compliance with ICD-10-CM, HCC guidelines, and CMS risk adjustment methodologies * Oversee quality outcomes from chart reviews and coding audits * Identify documentation gaps and implement ...
Ensure compliance with ICD-10-CM, HCC guidelines, and CMS risk adjustment methodologies * Oversee quality outcomes from chart reviews and coding audits * Identify documentation gaps and implement ...
$21.50 - $29.25/hr
... ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key ... Risk Adjustment / HCC knowledge required * Managed Care experience preferred
Quick apply
$21.50 - $29.25/hr
... ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key ... Risk Adjustment / HCC knowledge required * Managed Care experience preferred
Mcallen, TX · On-site
Minimum of two (2+) years in CMS HCC Risk Adjustment Coding. * Minimum of two (2+) years' experience in medical records, claims or billing area is an asset or equivalent combination of education and ...
Mcallen, TX · On-site
Minimum of two (2+) years in CMS HCC Risk Adjustment Coding. * Minimum of two (2+) years' experience in medical records, claims or billing area is an asset or equivalent combination of education and ...
Mcallen, TX · On-site
Minimum of two (2+) years in CMS HCC Risk Adjustment Coding. * Minimum of two (2+) years' experience in medical records, claims or billing area is an asset or equivalent combination of education and ...
Mcallen, TX · On-site
Minimum of two (2+) years in CMS HCC Risk Adjustment Coding. * Minimum of two (2+) years' experience in medical records, claims or billing area is an asset or equivalent combination of education and ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
$25.30 - $35.74/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 ...
$25.30 - $35.74/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 ...
$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 ...
$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 ...
$25.30 - $35.74/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 ...
$25.30 - $35.74/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 ...
Houston, TX · On-site
$25.30 - $35.74/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 ...
Houston, TX · On-site
$25.30 - $35.74/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 ...
Houston, TX · On-site +1
$25.30 - $35.74/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 ...
Houston, TX · On-site +1
$25.30 - $35.74/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 ...
Austin, TX · Remote
$600 - $720/day
Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Austin, TX · Remote
$600 - $720/day
Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Houston, TX · On-site
$150 - $190/hr
Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity. * Partner with Apex Medical leadership to align ...
Houston, TX · On-site
$150 - $190/hr
Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity. * Partner with Apex Medical leadership to align ...
$76K - $104K/yr
Provider Education and Audit Workflow ● Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity. ● ...
Quick apply
$76K - $104K/yr
Provider Education and Audit Workflow ● Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity. ● ...
Houston, TX · On-site
$143K - $229K/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 ...
Houston, TX · On-site
$143K - $229K/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 ...
Houston, TX · On-site
$76K - $104K/yr
Provider Education and Audit Workflow • Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity. • ...
Houston, TX · On-site
$76K - $104K/yr
Provider Education and Audit Workflow • Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity. • ...
Dallas, TX · On-site
$22.50 - $30/hr
While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding ... Clinic Coding experience REQUIRED * knowledgeable in ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and ...
Dallas, TX · On-site
$22.50 - $30/hr
While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding ... Clinic Coding experience REQUIRED * knowledgeable in ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and ...
| 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.
$22.10 - $38.25/hr
Full-time
This job post has expired today. Applications are no longer accepted.
8.5
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POSITION SUMMARY/RESPONSIBILITIES
The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with Centers for Medicare and Medicaid (CMS) and RADV guidelines. This role focuses on performing detailed audits, analyzing data, and collaborating with providers and internal teams to support Hierarchical Condition Categories (HCC) ratio goals and risk adjustment improvement initiatives. The auditor prepares customized reports based on data analysis and provides actionable recommendations to enhance operational and clinical performance. Additionally, the position assists in managing data collection processes and develops procedures for monitoring, validating, and reconciling data for accuracy. Working closely with cross-functional teams, the auditor supports compliance, quality assurance, and risk mitigation strategies while contributing to the development of tools and processes to improve coding accuracy and audit efficiency.
EDUCATION/EXPERIENCE
Bachelor’s degree required. Coding certification (such as CPC, CRC, or CCS) is preferred, or candidates must demonstrate a willingness to obtain certification within 6–12 months of hire. Applicants should have 1–2 years of healthcare experience; prior coding experience is preferred. Strong analytical and problem-solving skills, coupled with attention to detail, are essential. Candidates must possess the ability to learn and apply ICD-10-CM coding principles, exhibit excellent communication and organizational skills. Proficiency in health information systems, electronic health records (EHRs), HEDIS, RADV, and claims data analysis is a plus.
LICENSURE/CERTIFICATION
Coding certification within 2 years of employment (e.g., Certified Professional Coder - CPC, Certified Risk Adjustment Coder-CRC)
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