Confluence Health · 5 hours ago
HCC Code Reviewer
United States
Full-time
Remote
Entry, Mid Level
$24.86/hr - $39.66/hr
2+ years expConfluence Health is a community-focused healthcare provider located in Washington. The HCC Code Reviewer is responsible for maintaining and monitoring the quality of coding, ensuring compliance with CMS HCC Risk Adjustment coding guidelines, and collaborating with leadership to implement best practices.
Health CareHospitalMedical
Responsibilities
Review medical records to verify and ensure completeness, accuracy and compliance with applicable CMS HCC Risk Adjustment coding guidelines and regulations for services rendered
Ability to assign appropriate ICD-10 diagnosis codes
Serve as the HCC Risk Adjustment coding resource for diagnostic coding issues
Stay up to date with coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding
Maintain department coding production standards
Ensure compliance with all applicable Federal and/or State laws and regulations related to coding and documentation guidelines for Risk Adjustment encounters
Assist with coding audits to validate medical record documentation and coding accurately reflects coding based on CMS Hierarchical Condition Categories (HCC) as applicable to Medicare Risk Adjustment reimbursement initiatives
Collaborate with leadership to refine the HCC Risk Adjustment program through establishing education and feedback pathways and compliance strategies
Communicate professionally and effectively with providers and coders, educating them to ensure that correct HCC diagnosis codes are chosen based on documentation
Performs other tasks as requested by Supervisor, Manager or Director
Qualification
Required
High school diploma or equivalent GED
One of the following primary coding certifications: CPC, CIC, COC from American Academy of Professional Coders (AAPC) or CCA, CCS, CCS-P, RHIA, RHIT from American Health Information Management Association (AHIMA)
Second coding certification in Risk Adjustment Coding (CRC) from AAPC or ability to obtain CRC within six months of hire
Minimum 2-years coding experience
Comprehensive knowledge of ICD-10, CPT and HCPCS coding
Proficiency using Microsoft Office products guidelines
Preferred
Associate degree in business or related clinical field
Experience with EPIC EHR
Experience using distance learning/meeting programs
Strong qualitative and analytical skills
Excellent communication skills
Benefits
Medical, Dental & Vision Insurance
Flexible Spending Accounts & Health Saving Accounts
Paid Time Off
Generous Retirement Plans
Life Insurance
Long-Term Disability
Gym Membership Discount
Tuition Reimbursement
Employee Assistance Program
Adoption Assistance
Shift Differential
Company
Confluence Health
Confluence Health is a rural healthcare delivery system that provides safe and high-quality care.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Andrew Jones
Chief Executive Officer
Recent News
2025-10-21
Confluent Health companies
2025-06-26
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