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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Risk Adjustment and HCC coding, with a strong command of ICD-10-CM guidelines and compliance with HIPAA regulations. Capable of collaborating effectively with healthcare professionals to ensure accurate coding and documentation.
Highest-signal resume keywords
CPC CertificationCCS CertificationICD-10-CM CodingRisk Adjustment CodingCMS-HCC Methodology
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical CodingCoding AuditsData ValidationCoding Discrepancy ResolutionCoding Documentation Improvement
Soft Skills
Attention to DetailAnalytical SkillsCommunication SkillsInterpersonal SkillsIndependent Work
Tools & Technologies
Electronic Health Record (EHR) SystemsCoding SoftwareWindows Professional Edition
Certifications & Qualifications
CPC CertificationCCS CertificationCRC Certification
Industry Keywords
Risk AdjustmentHCC CodingICD-10-CMCMS-HCCHIPAA Compliance
About the role
Key responsibilities & impact- Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines
- Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines
- Validate the completeness, accuracy, and integrity of coded data
- Identify and resolve coding discrepancies between clinical documentation and diagnosis coding
- Stay up-to-date with coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding
- Adhere to compliance and HIPAA regulations to maintain data security and patient confidentiality
- Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries
- Participate in coding education and training programs
- Prepare and submit reports related to coding activities, accuracy, issues, or trends
- Assist in internal and external coding audits
- Identify opportunities for process improvement and efficiency
- Offer suggestions to enhance coding documentation and accuracy
Requirements
What you’ll need- Minimum CPC or CCS certification from AHIMA or AAPC is required
- CPC-A (Apprentice) certification will not be considered
- CRC (Certified Risk Adjustment Coder) certification is a significant advantage
- Minimum one to two years of experience in Risk Adjustment and HCC coding in a healthcare setting
- Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology
- Familiarity with electronic health record (EHR) systems and coding software
- Excellent attention to detail and analytical skills
- Ability to work independently
- Strong communication and interpersonal skills for collaboration with medical professionals and team members
- Understanding of compliance and confidentiality regulations, including HIPAA
- Availability to work from 6 AM to 6 PM EST
- Minimum commitment of 20 hours per week, Monday through Friday
- Windows-based laptop/desktop with Windows Professional Edition (Windows Pro)
- Reliable high-speed internet connection
- Windows Home Edition systems are not compatible with the role's security requirements
Benefits
Comp & perks- Bring Your Own Device (BYOD) policy
- Minimum commitment of 20 hours per week; preference for candidates committing to 40 hours per week