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Vice President Hcc Risk Adjustment Coder Jobs in New York

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Position: Risk-adjustment / HCC coding leader Type: Contract Compensation: $110/hour Location ... CRC (Certified Risk Coder) , CCS , CPC , or RHIA credential. * Experience with risk adjustment ...

Stanford Health Care

Sr Risk Adjustment Coder

Newark, NJ

$44.13 - $57.36/hr

The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare ...

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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 New York?

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

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

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Vice President Hcc Risk Adjustment Coder jobs near you

HCC Coding Leader - Risk Adjustment

Mercor

New York, NY • Remote

$110/hr

Full-time

Re-posted 16 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Risk-adjustment / HCC coding leader
Type: Contract
Compensation: $110/hour
Location: Remote

Role Responsibilities

  • Lead risk adjustment and HCC coding operations across Medicare Advantage, Medicaid, and ACA risk adjustment programs.
  • Evaluate AI-generated HCC coding assignments and risk adjustment recommendations for clinical accuracy and regulatory compliance.
  • Review medical records to ensure complete and accurate capture of HCC-eligible conditions supported by clinical documentation.
  • Conduct and oversee retrospective and prospective chart reviews for risk score optimization.
  • Manage RADV audit preparation and response processes.
  • Collaborate with clinical, coding, and compliance teams to improve documentation and coding for risk adjustment purposes.

Qualifications

Must-Have

  • 5+ years of experience in risk adjustment coding, HCC coding, or Medicare Advantage coding operations, with at least 2 years in a leadership role.
  • Deep expertise in CMS-HCC, RxHCC, and/or ACA HHS-HCC risk adjustment methodologies.
  • Strong knowledge of ICD-10-CM coding guidelines as applied to HCC risk adjustment.
  • Experience with RADV audit preparation and CMS compliance requirements.
  • Familiarity with RAPS and EDGE submission processes.
  • Exceptional written and verbal English communication skills.
  • High attention to detail with the ability to identify coding inaccuracies and documentation gaps in AI-generated outputs.

Preferred

  • CRC (Certified Risk Coder), CCS, CPC, or RHIA credential.
  • Experience with risk adjustment analytics platforms and chart retrieval systems.
  • Background in health plan, Medicare Advantage organisation, or value-based care setting.
  • Familiarity with AI-assisted HCC coding tools and comfort evaluating AI-generated risk adjustment content.
  • Experience presenting risk adjustment performance to actuarial or executive teams.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.