Join Pathways Health Partners, a leader in Value-Based Care and Medicare innovation across North-West/Central Florida, as an HCC Risk Coder. This role is critical in coordinating retrospective and concurrent chart reviews, facilitating education, and retrieving charts for Health Plan audits and reports. You will apply your expertise in Hierarchical Condition Categories (HCC) coding to accurately translate, input, extract, and validate medical record data.
Responsibilities include reviewing documentation to assign correct diagnosis codes from outpatient records, extracting data for Health Plan reports, assisting with obtaining medical records for audits, coordinating coding guideline training, verifying accuracy of HCC codes, assigning ICD-10-CM codes aligned with risk adjustment models, querying providers for documentation clarity, participating in clinical documentation improvement initiatives, and supporting special projects.
Qualifications:
- High School Diploma or GED required; Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) preferred.
- Knowledge of medical coding, documentation regulations, and professional communication skills.
- Training in Medicare Risk Adjustment, HCC coding guidelines, rules, and regulations.
- Minimum of two years experience in a medical or health plan environment.
- Proficiency in Outlook, MS Office, Excel, and Word.
Pathways Health Partners offers a competitive salary, excellent benefits including 100% paid medical insurance for employee and spouse/significant other, life insurance, vision and dental options, a 401K with company match, paid holidays, and generous paid time off. Join a professional yet family-oriented culture based in Leesburg, FL.
- High School Diploma or GED required; CRC or CPC certification preferred.
- Understanding of medical coding and documentation regulations.
- Training in Medicare Risk Adjustment and HCC coding documentation guidelines.
- At least two years' experience in medical or health plan settings.
- Strong computer skills including Outlook, MS Office Suite.
- Professional written and verbal communication skills.
- Ability to perform administrative tasks and coordinate training.
- 100% employer-paid medical insurance for employee and spouse/significant other.
- Low-cost family coverage options.
- $25,000 life insurance fully paid by employer.
- Vision and dental coverage at low employee cost.
- 401K retirement plan with 100% match up to 4%.
- Paid holidays and ample paid time off for vacation, sick, and personal days.
- Professional yet family culture with leadership engagement.
Location
Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago