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Vice President Hcc Risk Adjustment Coder Jobs in Pennsylvania

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Medical Coder

Philadelphia, PA · On-site

$14.80/hr

The coder will identify risk adjustment codes based upon coding guidelines. The coder will be knowledgeable and familiar with computers and technology. The coder will be a certified professional ...

Highmark Health

VP CMIO - AHN

Pittsburgh, PA · On-site

... risk adjustment, and claims data. * 5 years of experience in Proven track record of leading large ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...

Highmark Health

VP CMIO - AHN

Pittsburgh, PA · On-site

... risk adjustment, and claims data. * 5 years of experience in Proven track record of leading large ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...

Solventum

CDI Product Manager

Pittsburgh, PA · On-site +1

Serve as the subject matter expert in outpatient CDI workflows, risk adjustment, HCC capture, and coding compliance * Product Development & Execution * Translate business requirements into product ...

Healthcare

CDI Product Manager

Pittsburgh, PA

Serve as the subject matter expert in outpatient CDI workflows, risk adjustment, HCC capture, and coding compliance * Product Development & Execution * Translate business requirements into product ...

IQVIA

VP, Client Services

Philadelphia, PA

Ensure full delivery and management of all scoped work and/or identify any projects at risk ... Ensure staff understanding of appropriate SHEP numbers to code time and importance of reporting all ...

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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 Pennsylvania?

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

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Vice President Hcc Risk Adjustment Coder jobs near you

HCC Analyst, Practice Management

Du Bois, PA • On-site

Penn Highlands Healthcare
Health Care and Social Assistance • 1 - 5K employees

5.4

Company rating: 5.4 out of 10

Based on 116 frontline employees who took The Breakroom Quiz

834th of 895 rated healthcare providers

People enjoy working here

Recommended by students

Recommended by parents

Learn more about Penn Highlands Healthcareexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 9 days ago

Job description

THE HIERARCHICIAL CONDITION CATEGORY CERTIFIED (HCC) ANALYST PROVIDES QUALITY CODING SERVICES TO THE PENN HIGHLANDS PHYSICIAN NETWORK AND ASSISTS ALL PRACTICE STAFF IN PROPER CODING INITIATIVES. ASSIST IN THE PLANNING, ORGANIZING, AND PROVIDING EDUCATION RELATING TO CODING AND DOCUMENTATION GUIDELINES TO ALL STAFF, I.E., PHYSICIANS, PRACTITIONERS, AND ALL LEVELS OF STAFF IN ACCORDANCE TO THE REGULATORY AND COMPLIANCE POLICIES. COORDINATES THE PRACTICE EDUCATION AND MONITORING ACTIVITIES OF CLINICAL AND NON-CLINICAL STAFF. ACTS AS A LIAISON FOR THE PRACTICE STAFF WITH EDUCATIONAL OVERSIGHT.
QUALIFICATIONS:
  • ASSOCIATE'S DEGREE OR EQUIVALENT IN ASSOCIATED FIELD REQUIRED; CPC OR CCS-P CODING CERTIFICATION, APPRENTICE DESIGNATION NOT ACCEPTED. CRC RISK ADJUSTMENT CODER CERTIFICATION.
  • AT LEAST FIVE YEARS PHYSICIAN RECORD CODING EXPERIENCE. ABILITY TO DEMONSTRATE ICD-10 RISK ADJUSTMENT CODING ABILITY FROM A SAMPLING OF PHYSICIAN NOTES. EXPERIENCE IN PRESENTING CODING EDUCATION TO PROVIDERS.
  • GOOD WRITTEN, VERBAL, AND ELECTRONIC COMMUNICATION SKILLS. GOOD ORGANIZATIONAL SKILLS AND ABILITY TO WORK INDEPENDENTLY.

WHAT WE OFFER:
  • Competitive Compensation based on experience
  • Professional Development
  • Supportive and Experienced Peers

BENEFITS:
  • Medical, Dental, and Vision offered the first month after start date
  • Paid Time Off
  • 403(b) retirement plan with company match
  • Flex Spending Account
  • 25% discount on all services at Penn Highlands Healthcare facilities
  • Employee Assistance Program (EAP)
  • Health & Wellness Programs

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