HCC Medical Coder

What You Will Do

The HCC Risk Adjustment Medical Coder Specialist ensures the data integrity of coded patient records by reviewing the submitted medical documentation and validating that it accurately supports the assigned codes while following the Official Guidelines for Coding and Reporting. This position will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate HCC related ICD-10 Diagnosis codes. The HCC Coder will have the ability to identify encounter level discrepancies and documentation improvement opportunities for provider education, as well as identifying and communicating trending issues. The HCC Coder will query providers regarding missing, unclear or conflicting documentation utilizing designated query process.

• Perform Risk Adjustment Review and Coding
• Perform Retrospective and Prospective Coding for Value Based Plans
• Meet 95% Quality and Production standards

What You Will Need

• 5+ years medical coding experience
• High School Diploma or equivalent
• AAPC Credentials; CRC, CPC
• Minimum 3 years' experience in Risk Adjustment Coding
• Maintains a working knowledge of ICD-10 and CPT coding principles
• Good Oral and Written communication skills
• Extensive knowledge of Value Based Payor Plans and various Risk Adjustment Models

What Would Be Nice To Have

• AAPC Credentials: CDEO and/or CPMA
• Experience in physician education related to Risk Adjustment opportunities
• Analytical skills and knowledge in use of excel

What We Offer

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits Include

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at or via email at All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received, please contact Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Seniority level

• Associate

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• Business Consulting and Services