Top 3 Health coder hcc & risk adjustment Jobs in San Francisco, Ca

HEALTH CODER - HCC & RISK ADJUSTMENT
NORTH EAST MEDICAL SERVICES —Burlingame, CA
- $42.79 - $48.75 an hour
- Full-time
- Bachelor of Science
- Mid-level
- 3 years
Risk Adjustment Compliance Specialist, Principal
Blue Shield of California —Oakland, CA
- $148,940 - $223,300 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Office
- Work from home
Senior Consultant - Clinical Documentation Specialist
Deloitte —San Francisco, CA
- $110,700 - $218,300 a year
- Full-time
- Microsoft Word
- Nursing
- RN License

I want to receive the latest job alert for health coder hcc & risk adjustment in san francisco, ca

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

health coder hcc & risk adjustment jobs near san francisco, ca

Clinical Documentation Specialist jobs in San Francisco, CA

Compliance Officer jobs in Oakland, CA

Clinical Documentation Specialist jobs in Michigan

Peer Support Specialist jobs in Staten Island, NY

Clinical Documentation Specialist jobs in Pennsylvania

Clinical Documentation Specialist jobs in Long Island, NY

Clinical Documentation Specialist jobs in Tucson, AZ

Entry Level Clinical Research Associate jobs in Dallas Fort Worth, TX

Clinical Laboratory Scientist jobs in Kaiser, CA

Clinical Documentation Specialist jobs in Portland, OR

Coding Specialist jobs in Mandeville, LA

Coding Specialist jobs in Michigan

Coding Specialist jobs in Durham, NC

Prior Authorization Specialist jobs in New Jersey

Medical Billing Coding At Home jobs in Ohio

Coding Specialist jobs in South Carolina

Clinical Documentation Specialist jobs in Nashville, TN

Trade Compliance jobs in Remote

Loan Officer Assistant jobs in Phoenix, AZ

Compliance Officer jobs in Lexington, KY

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES -
Burlingame, CA

Apply Now

Job Details

Full-time
$42.79 - $48.75 an hour

Qualifications

Clinical staff training
Clinical training
Data-driven problem-solving
Clinical documentation improvement

Full Job Description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

HCC Coding and Risk Adjustment (RA) Program Support
- Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
- Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
- Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
Provider Training and Clinical Documentation Improvement (CDI)
Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
Data Analysis and Reporting
- Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
- Generate reports and dashboards to track coding performance and documentation accuracy.
- Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
Compliance and Continuous Improvement
- Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
- Assist in the development and implementation of internal coding policies and procedures.
- Participate in quality improvement initiatives related to coding and documentation.
- Performs other job duties as required by manager/supervisor

Education & Certification:
- BS/BA Degree in Health Science or General Education is required.
- Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
- Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
Experience:
- Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
- Experience in provider education, clinical documentation improvement (CDI), and chart audits.
- Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
Skills & Competencies:
- Excellent communication, presentation, and interpersonal skills.
- Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
- Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
- Proficiency in electronic health records (EHR) and coding software.
- Strong analytical and problem-solving skills.

LANGUAGE:

Must be able to fluently speak, read and write English.
Fluency in other languages is an asset.

STATUS:

This is an FLSA Non-exempt position.
This is not an OSHA high-risk position.
This a full-time position.

Apply Now

Refine Your Search

health coder hcc & risk adjustment jobs in san francisco, ca

HEALTH CODER - HCC & RISK ADJUSTMENT

Risk Adjustment Compliance Specialist, Principal

Senior Consultant - Clinical Documentation Specialist

I want to receive the latest job alert for health coder hcc & risk adjustment in san francisco, ca

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected