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Vice President Hcc Risk Adjustment Coder Jobs in Michigan

Tokio Marine HCC International

VP of Operations

Troy, MI · On-site

$180 - $280/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

## VP of OperationsApplyremote type: Hybridlocations: Michigan - Troytime type: Full timeposted on ... Tokio Marine HCC - Public Risk Group,** a member of the Tokio Marine group of companies, is a ...

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Tokio Marine HCC

VP of Operations

Troy, MI · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Role Details Job Title: VP of Operations Location: Troy, Michigan - Hybrid (3 days in-office, 2 ... HCC - Public Risk Group, a member of the Tokio Marine group of companies, is a market leader in ...

Tmhcc

VP of Operations

Troy, MI · Hybrid

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Role Details Job Title: VP of Operations Location: Troy, Michigan - Hybrid (3 days in-office, 2 ... HCC - Public Risk Group, a member of the Tokio Marine group of companies, is a market leader in ...

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Vice President Hcc Risk Adjustment Coder information

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.

How long does it take to become a vice president hcc risk adjustment coder?

Becoming a Vice President HCC Risk Adjustment Coder typically requires several years of experience in medical coding, risk adjustment, or healthcare management, often 5 to 10 years. Progression to this senior leadership role involves gaining expertise in coding accuracy, compliance, and leadership skills, along with relevant certifications such as CPC or CCS, and demonstrated success in managing risk adjustment programs.

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 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 the most commonly searched types of Hcc Risk Adjustment Coder jobs in Michigan?

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

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

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

Vice President Hcc Risk Adjustment Coder jobs near you

Risk Adjustment Coding Coordinator (onsite), full time, days

Holland Hospital

Holland, MI • On-site

$23.30 - $34.95/hr

Full-time

Re-posted 6 days ago

Holland Hospital rating

6.5

Company rating: 6.5 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

720th of 1,059 rated hospitals

Job description

CURRENT HOLLAND HOSPITAL EMPLOYEES- Please apply through Find Jobs from your Workday employee account.
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.
Qualifications:
Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hire
Experience with risk adjustment programs preferred.
Prior provider education or clinical collaboration experience preferred.
Excellent communication skills for provider education and stakeholder collaboration
Employment Type: Full Time
Shift: Mon-Thrs- 8am-4:30pm Fri- 8a-12p
Weekly Scheduled Hours: 36
Wage Range: $23.30 - $34.95 per hour
Weekend Requirements: NA
Requirements:
- High school diploma/GED or higher education
-Certified Professional Coder (C-CPC)
Clinical Documentation Review & Risk Adjustment Coding
  • Prepare and manage risk adjustment visit workflows, including maintaining patient lists, diagnosis summaries, and assisting with scheduling coordination.
  • Conduct comprehensive pre-visit chart reviews to identify and validate ICD-10-CM diagnoses that accurately represent each patient's health status.
  • Perform post-visit documentation analysis to ensure proper ICD-10-CM code assignment, diagnosis specificity, and compliance with MEAT (Monitor, Evaluate, Assess, Treat) criteria.
  • Maintain up-to-date knowledge of CMS risk adjustment regulations, HCC models, and clinical documentation and coding standards.
  • Support organizational value-based care goals by collaborating with Manager, Quality and clinical teams to ensure compliant risk adjustment documentation.

Provider Engagement, Education & Clinical Support
  • Serve as a clinical documentation and coding subject matter expert, supporting providers in achieving compliant and accurate risk adjustment practices.
  • Deliver ongoing education and feedback to providers and coders regarding documentation standards, diagnosis specificity, and optimal risk adjustment coding principles.
  • Identify documentation gaps or inconsistencies and communicate findings through structured, actionable feedback, including formalized documentation queries as needed.
  • Promote a culture of documentation excellence that supports quality outcomes, operational performance, and compliant value-based care delivery.

Audit, Reporting & Performance Monitoring
  • Conduct routine and targeted chart audits to assess documentation quality, coding accuracy, and HCC recapture performance.
  • Track, analyze, and report key risk adjustment performance indicators, including recapture rates, suspect condition closure, documentation accuracy, and provider-level trends.
  • Collaborate with operational leaders to integrate risk adjustment best practices into existing clinical workflows and identify opportunities for process improvement.
  • Participate in quality assurance initiatives, report findings to leadership, and support the development of corrective action plans or workflow enhancements.

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy

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