Risk Adjustment Coding Specialist

Employment Type: Full time Shift: Description: The HCC Risk Coder is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.

Position Purpose:

• Risk Adjustment Coding Specialist works in a team environment and is responsible for ensuring accurate ICD-9/10 documentation and capturing the HCC diagnostics code for the patient billing process.The HCC Risk Coder is responsible for accurately reviewing, analyzing, and coding medical diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, and regulatory requirements to support accurate reimbursement, risk score accuracy, and proper documentation practices. The coder collaborates with providers, auditors, and compliance teams to enhance coding quality while maintaining integrity in medical record reviews.
• Specialty: Medical Group
• Location: Remote
• Hours of office: Monday Friday: 5:30a 4:30p or 6:00p

What You Will Do:

• Reviews patient record prior to appointment to determine Gaps in Care, then communicates Gaps to provider.
• Recognizes opportunities for documentation improvement and educates providers and staff of suggested improvements.
• Collaborates with providers to formulate appropriate modifications to clinical documentation to reflect the appropriate use of clinical codes and documentation

Minimum Qualifications:

• Education: High school graduate or GED required
• Licensure / Certification:
  • CPC required
  • Certified Risk Adjustment Coder certification within one year of hire required.
• Experience: Minimum of two years of experience in medical coding and billing required

Position Highlights and Benefits:

• Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement.
• Relocation assistance (geographic and position restrictions apply).
• Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.
• Employee Referral Rewards program.
• Mount Carmel offers DailyPay - if youre hired as an eligible colleague, youll be able to see how much youve made every day and transfer your money any time before payday. You deserve to get paid every day!
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our four hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If youre seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.