HCC Coder

DaMar Staffing; Bushnell (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

PedIM Healthcare is seeking a proactive HCC Coder to join our Primary Care team. You will review records, identify RAF/HCC opportunities, and ensure accurate coding to support compliant risk adjustment under CMS guidelines.

Operate within a multi-disciplinary environment, collaborate with clinical teams, and stay current with regulatory updates to optimize RAF scores and documentation quality.

Qualifications

• 2+ years of HCC/Risk Adjustment coding experience required.
• Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models.
• Active coding credential preferred (CRC, CPC, CCS, or equivalent).

Responsibilities

• Review charts pre-visit and post-visit to identify RAF/HCC opportunities.
• Assign accurate ICD-10 and HCC codes and ensure documentation integrity.
• Collaborate with Clinical Integrity, Outreach, and Provider Teams on coding quality.

Skills

HCC/Risk adjustment coding

CMS risk adjustment knowledge

Documentation and chart audits

Provider education

Education

CRC/CPC/CCS credential (or equivalent)

Job description

Description:

Join the Team at PedIM Healthcare!

Delivering exceptional care, together.

Who We Are

PedIM Healthcare is the first private medical office of its kind in Citrus County offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, womens care, medical weight-loss, sleep-medicine services and more.

Our dedicated, community-focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County.

Why Work With Us?

• A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight-loss & sleep medicine specialties.
• A values-driven environment: we listen, we help, we understandand we care.
• Community-oriented and recognized: voted best of the best in the region.
• Opportunity to make a meaningful impact by supporting patients over their full life spanfrom children to seniors.
• A workplace committed to employee development and delivering holistic care.

The Role

We are seeking a proactive and compassionate HCC Coder to join our Primary Care team!

This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance with CMS guidelines while supporting high-quality patient outcomes. You will be responsible for reviewing medical records, identifying appropriate HCC diagnoses, ensuring documentation integrity, and collaborating closely with providers and clinical teams to optimize RAF scores and coding accuracy.

What You'll Do:

• Conduct pre-visit and chart reviews to identify known and suspected RAF/HCC conditions prior to patient appointments
• Conduct post-visit chart reviews to ensure all RAF/HCC opportunities have been captured by the medical provider prior to claims submission/billing
• Conduct post claims submission reconciliation from payer to ensure all codes have been properly accounted for through files such as MOA004, MOR and MMR
• Review provider documentation and assign accurate ICD-10 and HCC codes
• Identify documentation gaps and provide clear, actionable feedback to providers
• Track coding trends and identify performance improvement opportunities
• Collaborate closely with Clinical Integrity, Outreach, and Provider Teams
• Maintain established productivity and quality benchmarks
• Stay current with CMS risk adjustment guidelines and regulatory updates

Requirements:

Qualities That Make You A Great Fit:

• Minimum 2+ years of HCC/Risk Adjustment coding experience (required)
• Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models
• Active coding credential preferred (CRC, CPC, CCS, or equivalent)
• Proven experience with chart audits and provider education