HCC & ProFee Coder | Hospitalist/Primary Care

Dahl Consulting; Minnesota; Hybrid; USD 34,000 - 49,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401(k) plan

Phone stipend

Internet stipend

Paid time off

Holidays

Job summary

Dahl Consulting is seeking an experienced HCC & ProFee Coder for a remote contract-to-hire position in the Hospitalist/Primary Care space. The role focuses on high-level coding validation, risk adjustment auditing, and CDI activities for CMS HCC, Rx HCC, and ICD-10-CM guidelines.

Responsibilities include reviewing records, ensuring regulatory compliance, and collaborating with providers and project leadership while maintaining a 96% coding accuracy rate.

Qualifications

• Required CRC (Certified Risk Adjustment Coder) credential.
• Current AAPC or AHIMA credential (CPC/COC/CCS-P).
• Minimum 5 years of HCC-specific coding experience.
• Extensive ICD-10-CM, CMS HCC and Rx HCC knowledge.
• Proficiency with Excel, Word and EMR systems.

Responsibilities

• Review and validate diagnosis codes for ICD-10-CM compliance.
• Verify coding accuracy per project requirements.
• Perform CMS HCC and Rx HCC risk adjustment validation.
• Review CPT Category II coding and documentation for accuracy.
• Apply Medicare Wellness Visit coding guidelines.
• Document time worked and complete admin tasks.
• Maintain HIPAA and PHI privacy compliance.
• Communicate with providers for clarification as needed.

Skills

Attention to detail

Communication skills

Time management

Independent work

HIPAA compliance

Education

CRC credential

AAPC/AHIMA credential

Tools

Excel

Word

EMR systems

Coding audit software

Job description

Title: HCC & ProFee Coder | Hospitalist/Primary Care

Location: Remote

Job Type: Contract to Hire

Compensation: $30.00 per hour (W2)

Industry: Hospital & Healthcare

About the Role

Our firm is recruiting on behalf of a healthcare services client that supports health plans, provider organizations, and value-based care initiatives through advanced coding, risk adjustment, and documentation review services. We are seeking an experienced HCC & ProFee Coder to perform high-level coding validation, risk adjustment auditing, and clinical documentation review activities. This role is ideal for a coding professional with deep expertise in CMS HCC, Rx HCC, ICD-10-CM, and Medicare coding guidelines who thrives in a detail-oriented, quality-focused environment.

Job Description

The HCC & ProFee Coder is responsible for reviewing medical records to validate coding accuracy, ensure compliance with regulatory guidelines, and support risk adjustment and quality improvement initiatives. The position requires extensive knowledge of ICD-10-CM coding, HCC methodologies, provider documentation standards, and coding compliance requirements.

Key Responsibilities

• Review and validate diagnosis codes to ensure they are supported by clinical documentation and compliant with ICD-10-CM Official Coding Guidelines.


• Verify coding accuracy in accordance with project-specific coding and documentation requirements.


• Perform CMS HCC risk adjustment code validation and data abstraction review.


• Perform Rx HCC risk adjustment code validation and data abstraction review.


• Review CPT Category II coding and supporting documentation for accuracy and completeness.


• Apply Medicare Annual Wellness Visit coding and documentation guidelines.


• Enter coding and audit data accurately into client systems and reporting tools.


• Evaluate provider documentation quality and identify opportunities for clinical documentation improvement.


• Communicate with providers as needed to obtain coding clarification or missing documentation.


• Maintain a minimum coding accuracy rate of 96% and successfully meet quality standards during onboarding and ongoing audits.


• Collaborate with project leadership regarding assignments, workload management, schedule updates, and coding-related questions.


• Accurately document time worked and complete required administrative tasks.


• Ensure compliance with HIPAA, protected health information (PHI) requirements, and all applicable privacy regulations.


• Adhere to federal and state regulations, coding standards, and industry best practices.


• Perform additional duties as assigned.

Qualifications

• Required CRC (Certified Risk Adjustment Coder) credential.


• Ability to work 40 hours per week, Monday – Friday, 8:00am – 5:00pm CST.


• Current AAPC or AHIMA credential, including one of the following: CPC (Certified Professional Coder) COC (Certified Outpatient Coder) CCS-P (Certified Coding Specialist - Physician-Based).


• Minimum 5 years of HCC-specific coding experience.


• Extensive experience with ICD-10-CM coding, CMS HCC risk adjustment, Rx HCC risk adjustment, CPT Category II coding, Medicare Annual Wellness Visit coding, recent professional experience coding E/M services and ICD-10-CM diagnoses, strong understanding of CMS and HHS HCC hierarchies and risk adjustment models, advanced knowledge of medical terminology, anatomy, and clinical documentation requirements.


• Experience researching and applying coding regulations, guidelines, and compliance standards.


• Experience using coding audit and review software.


• Proficiency with Microsoft Excel, Word, and electronic medical record (EMR) systems.


• Exceptional attention to detail with strong written and verbal communication skills.


• Excellent organizational, time management, and prioritization abilities.


• Ability to work independently while maintaining high productivity and accuracy standards.


• Professional, positive, and collaborative approach to work.

Preferred

• Additional experience in risk adjustment auditing, provider education, and documentation improvement initiatives.


• Experience supporting quality improvement or value-based care programs.


• Multi-specialty physician coding experience.


• Familiarity with a variety of EMR platforms and healthcare technology tools.

Benefits

Our partner offers a comprehensive benefits package for full-time team members, including medical, dental, and vision insurance; company-paid life insurance; and a 401(k) retirement plan with company match. Employees also receive a phone and internet stipend, generous paid time off, seven company-observed holidays, and two floating holidays for personal observance. Additional perks include professional development opportunities, employee recognition programs, and the flexibility of a remote work environment designed to support work-life balance.

Equal Opportunity Statement

As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply.