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Vice President Hcc Risk Adjustment Coder Jobs in Tennessee

Vertek Staffing

HCC Risk Adjustment Coder

Franklin, TN · Remote

$18 - $24/hr

HCC / Risk Adjustment Coder - Remote Risk Adjustment / HCC Coding Experience Required Required Education * High School Diploma required with submission Required Certifications Online certification ...

Altegra Health

Remote Certified Coders

Memphis, TN · Remote

$21.75 - $29.75/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. ...

Altegra Health

Remote Certified Coders

Memphis, TN · On-site +1

$21.75 - $29.75/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Qualifications: • Active nursing license (RN or LPN) and/or certified coder certification through ...

Intermountain Health

HCC Coding Analyst 1

Nashville, TN · On-site

$28.06 - $44.20/hr

Certified Risk Adjustment Coder (CRC) through AAPC obtained within 1 year of hire Preferred Qualifications * CRC certification already obtained * ICD-CM diagnosis coding experience Physical ...

New

Urrly

Telehealth Nurse Practitioner

Nashville, TN · Remote

$600 - $720/day

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

OneOncology

VP, RCM Business Operations

Nashville, TN · On-site

Infusion and drug billing (e.g., J-codes, NDC mapping), prior * authorization for high-cost ... Compliance & Risk Management * Work with other RCM VP's to ensure adherence to CMS, OIG, HIPAA, and ...

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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 Tennessee? The most popular types of Hcc Risk Adjustment Coder jobs in Tennessee are:
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Vice President Hcc Risk Adjustment Coder jobs near you

HCC Risk Adjustment Coder

Vertek Staffing

Franklin, TN • Remote

$18 - $24/hr

Contractor

Re-posted 12 days ago

Job description

HCC / Risk Adjustment Coder - Remote

Risk Adjustment / HCC Coding Experience Required

Required Education
  • High School Diploma required with submission
Required Certifications

Online certification verification required with submission.

Candidates must possess one of the following certifications:

  • Certified Professional Coder (CPC) - AAPC
  • Certified Risk Adjustment Coder (CRC) - AAPC
  • Certified Coding Specialist (CCS) - AHIMA
  • Registered Health Information Technician (RHIT) - AHIMA
  • Registered Health Information Administrator (RHIA) - AHIMA

CRC Certification is highly preferred.

Schedule
  • Monday - Friday
  • Occasional weekend coverage may be required based on client needs
Position Summary

The HCC / Risk Adjustment Coder is responsible for reviewing medical records and clinical documentation to accurately identify, validate, and code chronic and acute conditions impacting patient risk scores and reimbursement.

The coder will ensure accurate assignment of ICD-10-CM diagnosis codes in accordance with CMS Risk Adjustment guidelines, Official ICD-10-CM Coding Guidelines, and client-specific requirements. This role supports Risk Adjustment initiatives through retrospective chart reviews, prospective reviews, coding validation, provider education support, and quality assurance activities.

The HCC Coder will collaborate with providers, CDI professionals, quality teams, population health departments, and coding leadership to ensure complete and accurate capture of chronic conditions and disease burden.

Key Responsibilities
  • Review medical records to identify and code HCC-eligible diagnoses.
  • Assign ICD-10-CM diagnosis codes in accordance with CMS and Risk Adjustment guidelines.
  • Validate chronic conditions and ensure documentation supports code assignment.
  • Perform retrospective and prospective chart reviews.
  • Identify missed HCC opportunities and documentation gaps.
  • Assist with coding validation and quality assurance audits.
  • Support provider education initiatives regarding Risk Adjustment documentation requirements.
  • Maintain productivity and quality standards established by the client.
  • Participate in internal and external audit activities.
  • Stay current on CMS Risk Adjustment regulations, coding updates, and industry best practices.
  • Assist leadership with special projects and additional duties as assigned.
Required Experience
  • Risk Adjustment / HCC coding experience required
  • Strong understanding of ICD-10-CM coding guidelines
  • Experience reviewing outpatient and provider documentation
  • Knowledge of CMS-HCC Risk Adjustment methodologies
  • Experience validating chronic conditions and disease burden
  • Strong attention to detail and coding accuracy
Preferred Experience
  • CRC certification
  • Experience with Medicare Advantage populations
  • Experience with value-based care programs
  • Experience performing coding audits and quality reviews
  • Experience with Epic, Cerner, Athena, eClinicalWorks, NextGen, or other EMR systems
  • Experience educating providers on Risk Adjustment documentation
 
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About Vertek Solutions

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Vertek Solutions is a boutique staffing firm that specializes in recruiting top level IT talent who can enhance our clients’ teams. Our team works every day to foster relationships with both our consultants and clients to understand their needs and ensure that we are providing a solution that is mutually beneficial.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Franklin, TN, US

Year founded

2006

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