HCC Risk Adjustment Coder
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Job Location:
Monthly Salary:
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
HCC Risk Adjustment Coder
About the Role
We are seeking an experienced Risk Adjustment Coder with strong knowledge of HCC coding CMS
guidelines RAF score calculation and accurate clinical documentation review. The ideal candidate will be
CRC/CPC certified and able to deliver high-quality coding with zero-compromise compliance standards.
Key Responsibilities
Review and analyze medical records charts and documentation to assign accurate ICD-10-CM
diagnosis codes for Risk Adjustment (HCC) models.
Ensure coding accuracy that aligns with CMS DX-HCC and internal compliance guidelines.
Validate clinical documentation to support submitted diagnoses and identify documentation gaps.
Work closely with QA/clinical teams to resolve coding queries and discrepancies.
Maintain productivity and accuracy standards as per organizational expectations.
Participate in continuous audits feedback sessions and training programs to improve coding
quality.
Assist in identifying trends risk areas and opportunities for documentation improvement.
Maintain confidentiality and compliance with HIPAA regulations.
Required Qualifications
Bachelors degree Life Sciences Nursing Pharmacy or related field.
Minimum 2 years of experience in Risk Adjustment / HCC Coding.
CRC or CPC certification is mandatory.
Strong understanding of CMS risk adjustment models ICD-10 guidelines and clinical terminology.
Skills & Competencies
Excellent knowledge of ICD-10-CM HCC mapping and coding compliance.
Strong analytical ability and attention to detail.
Ability to interpret physician documentation accurately.
Good communication and written skills.
Familiarity with EMR/EHR systems and coding platforms.
Key Skills
- Collection And Recovery
- Banking
- ABAP
- Insulation
- Investment Management
- Client Services
About Company
Senior System Administrator Onsite - Glendale, CA Reveleer is a healthcare data and analytics company that uses Artificial Intelligence to give health plans across all business lines greater control over their Quality Improvement, Risk Adjustment, and Member Management programs. With ... View more
