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HCC Coder / Risk Management Coding Manager

HealthOp Solutions

Scottsdale, arizona


Job Details

Full-time


Full Job Description

Introduction:
Join our dedicated healthcare team and play a pivotal role in maintaining accurate coding and effective risk management. We pride ourselves on fostering a collaborative environment where expertise is valued, and professional growth is encouraged.

Why work with us:
We offer competitive compensation, comprehensive benefits, and a supportive workplace in Scottsdale, AZ. Be part of a team committed to excellence in healthcare information management.

Overview of the Position

Job Title: HCC Coder / Risk Management Coding Manager

Location: Scottsdale, AZ (In Person)

Hours & Schedule: Full-Time

Salary / Hourly Rate: $70,000 - $90,000 / year

Benefits Offered: Medical, Dental, Vision Insurance, PTO/Sick Leave, 401(k)

Job Summary:

The HCC Coder / Risk Management Coding Manager plays a crucial role in our healthcare team. This individual ensures the accurate coding of medical records per the Hierarchical Condition Categories (HCC) model, manages risk associated with coding policies, and maintains compliance with healthcare regulations. Their expertise will drive the accuracy and efficiency of coding operations, safeguarding the organization against potential risks.

Job Duties & Responsibilities:

  • Ensure precise coding and abstraction of medical records using current ICD-10-CM codes for reimbursement, research, and maintaining comprehensive patient data.
  • Evaluate and document HCC codes accurately while adhering to coding guidelines and compliance standards.
  • Analyze health records to identify risk areas and ensure regulatory compliance.
  • Provide expert guidance to staff on HCC operations, risk adjustment coding, and regulatory updates.
  • Collaborate with providers and healthcare professionals for clear documentation and accurate coding.
  • Conduct audits and data quality checks to maintain high coding accuracy.
  • Address discrepancies or inconsistencies in medical documentation with providers.
  • Develop and manage training programs to keep coding staff updated on current regulations.
  • Monitor the effectiveness of risk management strategies and propose improvements.
  • Generate detailed reports for senior management on coding accuracy and risk assessments.
  • Collaborate with the healthcare team to resolve coding issues and implement risk mitigation strategies.

Prerequisites / License & Certification Requirements:

  • 2-3 years of risk adjustment coding in Primary Care/Family Medicine.
  • CRC Certification (or 5+ years of HCC coding experience).
  • Proven expertise in ICD-10-CM coding, CMS documentation requirements, and value-based care principles.
  • Experience with eClinicalWorks (eCW).

Requirements

  • 2-3 years of risk adjustment coding in Primary Care/Family Medicine.
  • CRC Certification (or 5+ years of HCC coding experience).
  • Proven expertise in ICD-10-CM coding, CMS documentation requirements, and value-based care principles.
  • Experience with eClinicalWorks (eCW).

Benefits

Salary / Hourly Rate: $70,000 - $90,000 / year

Benefits Offered: Medical, Dental, Vision Insurance, PTO/Sick Leave, 401(k)

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