{"schemaVersion":"jobsearcher.job.v1","id":"6ff19efcc6b54e31224de8e5","url":"https://jobsearcher.com/jobs/6ff19efcc6b54e31224de8e5","canonicalUrl":"https://jobsearcher.com/jobs/6ff19efcc6b54e31224de8e5","title":"Medical Coder (HCC Coder)","description":"Job Summary:The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI).Key Job Functions:Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Client’s IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set.Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for data capture, through the lens of HHS’ Risk Adjustment.Perform various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of Quality Audits for vendor coding partners.Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners.Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely manner.Communicate effectively across all audiences (verbal & written).Develop and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to Client’s IFP Coding Guideline updates and policy determinations, as needed.Education & Experience:The Quality Review & Audit Analyst will have a high school diploma and at least 2 years’ experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC):Certified Professional Coder (CPC)Certified Coding Specialist for Providers (CCS-P)Certified Coding Specialist for Hospitals (CCS-H)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)Certified Risk Adjustment Coder (CRC) certificationMinimum QualificationsExperience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CMcoding guidelines and conventionsFamiliarity with CMS regulations for Risk Adjustment programs and policies related to documentation and coding compliance, with both Inpatient and Outpatient documentationHCC coding experience preferredComputer competency with excel, MS Word, Adobe AcrobatMust be detail oriented, self-motivated, and have excellent organization skillsUnderstanding of medical claims submissions is preferredAbility to meet timeline, productivity, and accuracy standardsEEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”","company":"Mindlance","rawCompany":"mindlance","city":"Denver","state":"CO","isRemote":false,"isActive":false,"createdAt":"2026-09-18T09:16:53.466Z","occupations":[{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"},{"code":"29-2072.00","title":"Medical Records Specialists","slug":"medical-records-specialists"},{"code":"15-2051.02","title":"Clinical Data Managers","slug":"clinical-data-managers"}],"industries":[{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"},{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"},{"code":"621111","title":"Offices of Physicians (except Mental Health Specialists)","slug":"offices-of-physicians-except-mental-health-specialists"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Medical Coder (HCC Coder)","description":"Job Summary:The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI).Key Job Functions:Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Client’s IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set.Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for data capture, through the lens of HHS’ Risk Adjustment.Perform various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of Quality Audits for vendor coding partners.Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners.Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely manner.Communicate effectively across all audiences (verbal & written).Develop and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to Client’s IFP Coding Guideline updates and policy determinations, as needed.Education & Experience:The Quality Review & Audit Analyst will have a high school diploma and at least 2 years’ experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC):Certified Professional Coder (CPC)Certified Coding Specialist for Providers (CCS-P)Certified Coding Specialist for Hospitals (CCS-H)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)Certified Risk Adjustment Coder (CRC) certificationMinimum QualificationsExperience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CMcoding guidelines and conventionsFamiliarity with CMS regulations for Risk Adjustment programs and policies related to documentation and coding compliance, with both Inpatient and Outpatient documentationHCC coding experience preferredComputer competency with excel, MS Word, Adobe AcrobatMust be detail oriented, self-motivated, and have excellent organization skillsUnderstanding of medical claims submissions is preferredAbility to meet timeline, productivity, and accuracy standardsEEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”","datePosted":"2026-09-18T09:16:53.466Z","dateModified":"2026-09-18T09:16:53.466Z","hiringOrganization":{"@type":"Organization","name":"Mindlance","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Denver","addressRegion":"CO","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"6ff19efcc6b54e31224de8e5"},"url":"https://jobsearcher.com/jobs/6ff19efcc6b54e31224de8e5"}}