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Vice President Hcc Risk Adjustment Coder Jobs in Florida

Msmc

Certified Risk Adjustment Coder

Hialeah, FL · On-site

$20.50 - $27.75/hr

Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... risk adjustment coding * Demonstrates understanding of risk adjustment payment models * Uses ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...

Centrum Health

Risk Adjustment Data Analyst

Doral, FL · On-site

Using SQL code, mine data on medical spend, clinical data and population health data and derive ... Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP ...

Centrum Health

Risk Adjustment Data Analyst

Doral, FL · On-site

Using SQL code, mine data on medical spend, clinical data and population health data and derive ... Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP ...

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Vice President Hcc Risk Adjustment Coder information

What is a Vice President HCC Risk Adjustment Coder?

A Vice President HCC (Hierarchical Condition Category) Risk Adjustment Coder is a senior executive responsible for overseeing the medical coding operations related to risk adjustment in healthcare organizations. They lead teams that ensure accurate coding of patient diagnoses and health information, which impacts how healthcare providers are reimbursed by insurance payers, especially Medicare Advantage plans. Their role typically involves compliance oversight, quality assurance, training coders, and strategic planning to optimize risk scores. These professionals require extensive experience in medical coding, deep knowledge of HCC models, and strong leadership skills. They play a critical part in helping organizations maximize compliant reimbursement and improve patient outcomes.

What are the key skills and qualifications needed to thrive as a Vice President HCC Risk Adjustment Coder?

To thrive as a Vice President HCC Risk Adjustment Coder, you need deep expertise in HCC coding, risk adjustment methodologies, healthcare regulations, and a relevant certification such as CPC, CRC, or CCS. Mastery of coding software, EHR systems, and data analytics platforms is typically required. Leadership, strategic thinking, attention to detail, and strong communication skills distinguish top performers in this role. These skills are crucial for ensuring coding accuracy, regulatory compliance, and driving organizational success in value-based care environments.

What are some common challenges faced by a Vice President HCC Risk Adjustment Coder, and how can they be managed?

A Vice President HCC Risk Adjustment Coder often faces the challenge of ensuring coding accuracy and compliance across large teams while keeping up with evolving CMS guidelines. Managing remote or distributed coding staff, integrating new technology solutions, and balancing productivity with quality assurance are also common hurdles. Success in this role requires strong communication skills, ongoing coder education, and the implementation of robust audit processes to maintain data integrity and regulatory compliance.

What is the difference between Vice President Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?

AspectVice President Hcc Risk Adjustment CoderHcc Risk Adjustment Coder
CredentialsAdvanced certifications, leadership experienceCertifications like CPC, CCS, or RHIT
Work EnvironmentExecutive-level, strategic planningOperational, coding departments
Industry UsageUsed in large healthcare organizations, insurersCommon in hospitals, clinics, coding firms

The Vice President Hcc Risk Adjustment Coder focuses on strategic leadership and oversight of risk adjustment coding programs, often requiring advanced certifications and leadership skills. In contrast, the Hcc Risk Adjustment Coder handles day-to-day coding tasks, ensuring accurate HCC coding based on medical records. Both roles are vital in healthcare risk management but differ mainly in scope, responsibilities, and experience level.

What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Florida?

The most popular types of Hcc Risk Adjustment Coder jobs in Florida are:

What are popular job titles related to Vice President Hcc Risk Adjustment Coder jobs in Florida?

For Vice President Hcc Risk Adjustment Coder jobs in Florida, the most frequently searched job titles are:

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The top searched job categories for Vice President Hcc Risk Adjustment Coder jobs in Florida are:

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Cities in Florida with the most Vice President Hcc Risk Adjustment Coder job openings:

Vice President Hcc Risk Adjustment Coder jobs near you
Infographic showing various Vice President Hcc Risk Adjustment Coder job openings in Florida as of August 2026, with employment types broken down into 92% Full Time, and 8% Contract. Highlights an 60% In-person, and 40% Remote job distribution.

HCC Risk Coder (CDIS) - Remote in FL

Pathways Health Partners

Leesburg, FL • On-site, Remote

$16.75 - $22.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Key responsibilities

  • Review and assess documentation to accurately translate chronic conditions into the appropriate diagnosis codes from outpatient medical records.

  • Extract data for Health Plan reports and input data collected from HCC programs.

  • Assist in obtaining medical records from Providers to support audits requested by Health Plans.

Job description

Description
Welcome to Pathways Health Partners, the Accountable Care Organization (ACO) that's leading the charge in helping independent providers transition to Value-Based Care.
What We Do:
Medicare REACH ACO: We're at the forefront of Medicare innovation.
Medicare Advantage MSO: Providing top-notch services to our Medicare Advantage patients.
Commercial MSO: Managing care for approximately 16,000 patients across North-West/Central Florida.
Where We Operate: From The Villages to St. Petersburg, and across to Mount Dora, we've got you covered!
Our Services:
Hospital Medicine Group: Delivering exceptional care in hospitals.
Affiliated Medical Practices: Managing several top-tier medical practices.
Insurance Agency: Offering comprehensive insurance solutions.
Join us on our journey to better health and value-based care!
Job Summary
The HCC Risk Coder plays a vital role in coordinating and supporting retrospective and concurrent chart reviews while providing education and facilitating chart retrieval for Health Plan audits and reports. This position requires a comprehensive understanding of Hierarchical Condition Categories (HCC) coding to accurately translate, input, extract, and validate medical record data.
Position Responsibilities:
• Review and assess documentation to accurately translate chronic conditions into the appropriate diagnosis codes from outpatient medical records.
• Extract data for Health Plan reports and input data collected from HCC programs.
• Assist in obtaining medical records from Providers to support audits requested by Health Plans.
• Help coordinate training sessions for Physicians and staff on relevant coding guidelines and compliance standards.
• Review provider documentation to verify that HCC codes are accurate and meet required documentation guidelines.
• Assign appropriate ICD-10-CM codes that map to risk adjustment models and identify documentation discrepancies, querying providers for clarity when necessary.
• Participate in clinical documentation improvement initiatives and maintain regular attendance at team meetings.
• Handle special projects as assigned and perform other duties as needed.
Qualifications and Education Requirements
  1. High School Diploma or GED. An active CRC (certified risk adjustment coder) or CPC (certified professional coder) preferred.

2. Understanding of regulations regarding medical coding and documentation; Administrative responsibilities, professional written and verbal communication, typing skills.
3. Documented training in Medicare Risk Adjustment (MRA), HCC coding documentation guidelines, rules, and regulation.
4. Two years' demonstrated experience in a medical or health plan environment
5. Excellent computer skills with experience in Outlook, MS Office, MS Excel, MS Word
Pathways Health Partners is a growing company based in Leesburg, FL. We are proud of our professional yet family culture with the executive team working daily alongside our team members. We provide competitive salaries and a benefits package that is second to none.
  • Medical Insurance for Employee and Spouse/Significant Other paid up to 100% by Pathways!
  • Addition of family coverage for dependents at a fraction of the cost
  • 25K life insurance for employees 100% paid by Pathways!
  • Increasing Employee coverage or adding spouse/dependents at a fraction of the cost
  • Vision and Dental Coverage available at a very low cost for employees, spouses, and family
  • 401K retirement plan with 100% match up to 4% of annual pay
  • Paid holidays
  • Ample Paid Time Off (PTO) for vacation/sick/personal days

We look forward to speaking with you about this opportunity!

Apply