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Trainee Hcc Risk Adjustment Coding Jobs in Washington

Quadrant

Nurse Practitioner

Reston, VA · On-site

$68/hr

... HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs) Passion for teamwork and the opportunity to ...

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Trainee Hcc Risk Adjustment Coding information

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?

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 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 are popular job titles related to Trainee Hcc Risk Adjustment Coding jobs in Washington?

For Trainee Hcc Risk Adjustment Coding jobs in Washington, the most frequently searched job titles are:

What job categories do people searching Trainee Hcc Risk Adjustment Coding jobs in Washington look for?

The top searched job categories for Trainee Hcc Risk Adjustment Coding jobs in Washington are:

What cities in Washington are hiring for Trainee Hcc Risk Adjustment Coding jobs?

Cities in Washington 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 Washington as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution.

Billing and Claims Analyst

Annapolis, MD • On-site

Porter Cares, Inc.
See more jobs at Porter Cares, Inc.external

$58K - $75K/yr

Full-time

Re-posted 10 days ago

Job description

Porter is hiring a Billing & Claims Analyst to join our Team!
Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.
ABOUT THE ROLE
Our organization operates in a payer-contracted services model - delegated services, in-home assessments, HEDIS gap closure, and risk adjustment visits - billed through Athena in a mix of penny-claim/encounter-reporting and full-cost claim arrangements. Because Athena's default logic is built for traditional fee-for-service billing, our claims regularly get flagged, held, or underpaid in ways that don't reflect actual problems.
We're hiring a Billing & Claims Analyst to be the day-to-day set of eyes on our claims: tracking what's been submitted, what's stuck, what's been paid, and what's been invoiced separately - and flagging patterns to the Revenue Cycle & Claims Operations Lead so they can be fixed at the source.
KEY RESPONSIBILITIES
Reporting & Reconciliation
  • Build and maintain recurring reports in Athena covering claim submission status, hold/edit queues, and payment status.
  • Reconcile claims sent to payers against invoices sent separately for encounter/penny-claim arrangements, confirming amounts match and nothing has fallen through the cracks.
  • Track partial payments and underpayments, flagging cases where Athena has applied a standard allowable amount or co-insurance deduction that conflicts with the actual contracted rate.
  • Maintain claim-aging reports so nothing sits in a hold queue unnoticed.

Claims Monitoring & First-Line Troubleshooting
  • Monitor daily/weekly claim submission activity to confirm claims are actually reaching payers, not just leaving Athena.
  • Review current holds in Athena, distinguish routine/expected holds from ones tied to our known penny-claim or allowable-amount issues, and route the latter for escalation.
  • Perform basic first-line correction on claims where the fix is known and documented, escalating anything new or ambiguous.

Support for Systemic Fixes
  • Document recurring issues (e.g., a specific hold code affecting a specific payer or claim type) with enough detail for the Operations Lead to escalate to Athena or the payer.
  • Support testing and validation whenever a new custom rule or workflow change is implemented in Athena, confirming it behaves as expected across a sample of claims.
  • Contribute claim-level detail to the 90-day Athena assessment and any future EMR evaluation.

REQUIRED QUALIFICATIONS
  • 1-3+ years of experience in medical billing, claims processing, or revenue cycle operations.
  • Working proficiency in Athena (or comparable EMR/RCM system) - running reports, navigating claim status and hold queues, and pulling claim-level detail.
  • Strong Excel skills (pivot tables, VLOOKUP/XLOOKUP, basic reconciliation building); SQL or other data-query experience is a plus but not required.
  • High attention to detail and comfort with repetitive reconciliation work - this role lives in the data, not just the summary.
  • Clear written communication for documenting issues and escalations.

PREFERRED QUALIFICATIONS
  • Prior exposure to value-based care, risk adjustment, HEDIS, or delegated/capitated billing models.
  • Experience with encounter data reporting or non-standard (non-FFS) claim types.
  • Familiarity with payer portals for claim status verification.

$58,000 - $75,000 a year
COMPENSATION & BENEFITS
Competitive wage and benefits package.
Full Equipment provided.
Opportunities for professional growth and continuing education.
A supportive, collaborative work environment.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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