The Value Based Coder II is an experienced professional within the Quality Management/Risk team responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, focusing on Hierarchical Condition Categories (HCC).
Key responsibilities include comprehensive record review and HCC expertise, advanced documentation improvement and provider education, compliance with federal and state coding guidelines, and collaboration on process improvement initiatives.
This role also involves developing and delivering educational content to providers to improve clinical documentation and supporting HCC coding capture. The coder monitors evolving coding guidelines and CMS regulations to ensure compliance and protects patient confidentiality following all relevant policies including HIPAA.
- Minimum 2 years of experience in outpatient coding.
- Minimum 2 years focused on risk adjustment and HCC principles.
- Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC coding guidelines and risk adjustment models.
- Strong understanding of federal and state guidelines on coding systems and sponsored programs.
- Proficiency in developing and delivering educational content.
- Effective interpersonal, communication, and presentation skills.
- Ability to manage multiple priorities and work independently.
- Computer literacy in medical information systems, records management software, and encoder software.
Preferred:
- 4+ years of experience in outpatient coding.
- 3+ years focused on risk adjustment and HCC principles.
Location
Houston, Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago