HCC Risk Adjustment Coder (ICD-10-CM/CPT)

Northeast Community Clinic; Alhambra (CA); On-site; USD 70,000 - 90,000; Full time

Job summary

Northeast Community Clinic is seeking an HCC Coder to evaluate accuracy and consistency of coded clinical data, collaborating with Billing Manager and Medical Director on ICD-10-CM, CPT, E/M, and documentation to ensure compliant outpatient coding.

The role involves reviewing medical records, training staff on Medicare coding guidelines with emphasis on HEDIS and Risk Adjustment HCC, and leading coding process improvements. Some evening/weekend hours may be required in a full-time capacity.

Qualifications

• BA degree preferred; coding certificate preferred (CCS/CPC).
• 2+ years experience in Healthcare Field as a Coder.
• Knowledge of ICD-10-CM, CPT, HCPCS and HCC coding required.

Responsibilities

• Review of medical records to ensure accuracy and coding completeness.
• Communicate with providers when documentation is inadequate or unclear for coding purposes.
• Create training presentations on Medicare coding guidelines focusing on Quality Measures, HEDIS, and Risk Adjustment HCC.
• Lead development and implementation of new coding processes, policies, and procedures.
• Attend weekly meetings to present HCC Risk Adjustment Coding feedback and provide workflows.
• Attend Coding/Billing trainings and debrief management and providers.
• Other duties as assigned by Billing Manager, Medical Director, Finance Director, or Executive Director.

Skills

EHR Proficiency

MS Office

Excellent communication

Team player

Education

BA Degree in Healthcare

Coding Certificate (CCS/CPC)

2+ years healthcare coder experience

Job description

Northeast Community Clinic is seeking an HCC Coder to evaluate accuracy and consistency of coded clinical data, collaborating with Billing Manager and Medical Director on ICD-10-CM, CPT, E/M, and documentation to ensure compliant outpatient coding.

The role involves reviewing medical records, training staff on Medicare coding guidelines with emphasis on HEDIS and Risk Adjustment HCC, and leading coding process improvements. Some evening/weekend hours may be required in a full-time capacity.