HCC Coding Specialist - Exempt - Full Time - Days - Covina (on-site)

Emanate Health; Covina (CA); Hybrid; USD 48,000 - 71,000; Full time

Job summary

Emanate Health in Covina is seeking an experienced HCC Coding Specialist to oversee HCC and STAR coding for Medicare and California plans. This on-site role partners with IPA directors, health plans, physicians, and billing staff to ensure accurate documentation and optimal risk adjustment outcomes.

The ideal candidate holds CPC/CRC/CCS or equivalent certification, with 1–5 years’ Medicare HCC coding experience, ICD-10-CM and CPT knowledge, and proficiency in Excel, PowerPoint, and Word.

Qualifications

• Associate degree or higher with relevant coursework.
• 1+ year Medicare HCC coding experience within IPA/HMO/clinic.
• Proficiency in ICD-9/ICD-10 and CPT coding guidelines.
• Excel, PowerPoint, and Word for data analysis and reporting.
• Knowledge of HIPAA and documentation standards.

Responsibilities

• Oversee HCC and STAR coding for Medicare and Covered California.
• Collaborate with IPA Director, health plans, physicians and billing staff.
• Educate providers on risk adjustment and coding guidelines.
• Analyze data, generate reports, and present performance metrics.

Skills

Customer service

HCC risk adjustment

STAR measures

ICD-10-CM

CPT coding

Excel

PowerPoint

Word

Medicare Advantage

Medical records

Verbal communication

Written communication

Analytical

Organizational skills

EMR systems

Cozeva

Meditech

Education

Associate degree

Medical Terminology

Anatomy & Physiology

Tools

Cozeva

Meditech

Job description

## HCC Coding Specialist - Exempt - Full Time - Days - Covina (on-site)Apply: Emanate Health Corporate Badillo St. - Covina: Full time: Posted Today: R0014630# **Current Emanate Health Employees - Please log into your Workday account to apply**Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals.On Glassdoor's list of \"Best Places to Work\" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.**J****ob Summary**The HCC Coding Specialist is responsible for the oversight and execution of HCC (Hierarchical Condition Category) and STAR Measures–related coding functions. This role collaborates closely with the IPA Director, Health Plan partners, MSO personnel, physicians, and billing staff to ensure accurate documentation, coding compliance, and optimal risk adjustment outcomes.The HCC Coding Specialist ensures the IPA’s Risk Adjustment Factor (RAF) maintains or exceeds 1.0 and supports achieving or improving a 4.0 STAR Rating or higher. This position plays a critical role in provider education, medical record review, claims validation, and performance reporting for Medicare and Covered California lines of business.# Job Requirements## **Minimum Education Requirement :**Associate degree preferred; college degree preferred with coursework in Medical Terminology, Anatomy & Physiology.## Minimum Experience Requirement :Minimum of one (1) year experience in Medicare HCC program within IPA, HMO, or clinic setting. Two to five (2-5) years of coding experience using ICD-9, ICD-10 and CPT coding systems. Excellent customer service skills required. Strong knowledge of HCC risk adjustment methodology and STAR measures. Proficiency in ICD-10-CM and CPT coding guidelines. Required experience using Microsoft Excel, PowerPoint, and Word, including data analysis, reporting, and presentation development. Experience working with Medicare Advantage. Ability to interpret medical records and claims data accurately. Strong written and verbal communication skills.Detail-oriented with strong analytical and organizational skills. Experience working with EMRs, claims systems, and risk adjustment tools (e.g., Cozeva, Meditech, or similar platforms) preferred.## Minimum License Requirement :Certified Professional Coder (CPC), CRC, CCS, or equivalent certification required.Delivering world-class health care one patient at a time.Pay Range:$34.50 - $51.31