HCC Coding Specialist
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AI Summary
The role involves reviewing medical records to assign accurate HCC codes and ensuring compliance with CMS risk adjustment guidelines. The specialist will collaborate with clinical staff to clarify documentation and prepare reports to support risk adjustment programs.
Benefits:
- 401(k)
- 401(k) matching
- Bonus based on performance
- Company parties
- Dental insurance
- Employee discounts
- Free food & snacks
- Health insurance
- Opportunity for advancement
- Paid time off
- Parental leave
- Savings bank
- Training & development
- Vision insurance
- Wellness resources
About the Role:
MedPOINT Management in Sherman Oaks, CA is looking for a detail-oriented HCC Coding Specialist to join our growing team. This is an exciting opportunity to play a critical role in risk adjustment accuracy and quality healthcare documentation. If you're passionate about medical coding and making a meaningful impact in managed care, we want to hear from you!
Responsibilities:
- Review and analyze medical records to assign accurate HCC (Hierarchical Condition Category) codes
- Ensure proper documentation of chronic conditions and risk adjustment diagnoses in compliance with CMS guidelines
- Conduct retrospective and prospective chart reviews to identify coding gaps and opportunities
- Collaborate with physicians and clinical staff to clarify documentation and support coding accuracy
- Prepare and submit coding findings and reports to support risk adjustment programs
- Stay current with ICD-10-CM coding updates, CMS risk adjustment models, and payer-specific requirements
- Support audit processes and respond to coding queries in a timely manner
Requirements:
- Certified Professional Coder (CPC), CRC, or equivalent coding certification required
- Minimum 2+ years of experience in HCC coding and/or risk adjustment
- Strong working knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment models
- Experience with medical record review in a managed care or health plan environment preferred
- Proficiency with electronic health records (EHR) and coding software
- Exceptional attention to detail and commitment to coding accuracy and compliance
- Strong communication skills with the ability to work collaboratively across clinical and administrative teams
About Us:
MedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to supporting high-quality, coordinated patient care across Southern California. Our provider partners and health plan clients trust us for our expertise, integrity, and commitment to operational excellence. We foster a collaborative and supportive work environment where talented professionals can thrive and grow their careers in healthcare management.
This is a remote position.
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