Strategic Risk Adjustment Coder - HCC & Compliance Advocate

VNS Health; New York (NY); On-site; USD 97,079,000 - 121,350,000; Full time

Benefits offered by this job

Referral bonus

PTO + holidays

Health insurance

401k plan

Wellness programs

FSAs

Job summary

VNS Health is seeking a skilled Medical Coder with Risk Adjustment expertise to review provider documentation and assign ICD-10 codes aligned with CMS HCC methodology. You will monitor coding accuracy and participate in data validation, audits, and training across departments.

Applicants should have at least two years of payor experience, knowledge of ICD-10-CM, CPT-4, HCPCS, and HIPAA; willingness to collaborate with care teams and leadership to improve compliance and outcomes.

Qualifications

• Minimum two years of payor work experience with medical records.
• Knowledge of ICD-10-CM, HCPCS and CPT-4 coding.
• Strong knowledge of HIPAA and regulatory guidelines.

Responsibilities

• Conducts coding reviews to assign correct ICD-10 codes per CMS HCC guidelines.
• Performs monthly internal data validation of Risk Adjustment diagnoses.
• Educates providers and staff on coding and regulatory changes.
• Supports auditing, training, and documentation accuracy across departments.

Skills

ICD-10 coding

HCC coding

CMS guidelines

Data validation

Auditing

Compliance

Provider engagement

Education

Bachelor's degree or equivalent

Tools

Electronic health records (EHR)

Job description

VNS Health is seeking a skilled Medical Coder with Risk Adjustment expertise to review provider documentation and assign ICD-10 codes aligned with CMS HCC methodology. You will monitor coding accuracy and participate in data validation, audits, and training across departments.

Applicants should have at least two years of payor experience, knowledge of ICD-10-CM, CPT-4, HCPCS, and HIPAA; willingness to collaborate with care teams and leadership to improve compliance and outcomes.