HCC Risk Adjustment Coder

Job Title: HCC Risk Adjustment CoderLocation: Hybrid -Verona, NJ&RemoteSchedule: Monday through Friday;40 hours/weekEmployment Type: Full Time; ExemptReports To: Director,Clinical Quality & TransformationThe HCC Coder is an essential administrative member of our dynamic health care team, focused on supporting the activities of the Population Health Department through various clerical duties. Excellent time management andanability to work as part of a team are essential skills for this role.Willingto train the right candidate.ESSENTIAL DUTIES AND RESPONSIBILITIES(included but not limited to):Accurate data management including the retrieval of hospital records and obtaining reports from specialists and health care providers.Manage data entry on multiple spreadsheets to track workflows and outcomes.Ability to review documentation and abstract all codes with specific emphasis onidentifyingthe mostaccurateseverity of illness according to CMS HCC (Hierarchical Conditions Categories) guidelines.Effectively uses computerassistedcoding tools to review and interpret medical records and applies in-depth knowledge of coding principles tovalidatemissing,incompleteor incorrect CPT and diagnosis codes.Abstracts, sequences and assigns diagnosis and procedures codes according to CMS HCC and all CPT and ICD 9 & 10 guidelines.Demonstrates advanced knowledge of medical terminology,anatomyand physiology.Follows up on all outstanding and incomplete provider billing summaries to ensure proper coding.Attend training, meetings and presentations associated with the Population Health Department and theVanovaHealthorganization asrequired.Perform administrative duties including copying, report collation, organizational tasks, and otherduties asassigned by Manager.Serve as the subject matter expert on HCC documentation requirements and ICD-10 coding guidelines.Strong understanding of the HCC concepts and impact on Population Health Risk Adjustment reimbursement initiatives.Effectively use computer assisted coding tools to review and interpret medical records and apply knowledge of coding principles to validate missing, incomplete, or incorrect CPT and diagnosis codes.Assistsin orienting, training, and mentoringnew staffand physicians.Review HCC suggestions from 3rd party HCC platforms daily. Advance suggestions to providersbaseonpatient’sdocumented history. Suggestions must be reviewed prior to apatientnext visit. Demonstrates knowledge of medical terminology, anatomy, and physiology.Follows up on all outstanding and incomplete provider billing summaries to ensure proper coding.Ascertain that coding efficiency and accuracy are improved by performing independent audits of physician records.Maintain at least 95% on both coding accuracy and completeness audits.Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Personal Health Information.WORK ENVIRONMENT/PHYSICAL DEMANDSOffice setting, with extended periods of sitting and computer workQualifications:Associate’s degree minimum, bachelor’s degree preferredWork experience in a community or medical health care setting is a plus.PreviousHER knowledgerequired, Athena a plus1+ year of auditing experienceProficient use of Microsoft Office Applications (Excel, Word, PowerPoint).Coding Certification (CPC, CRC, CCS-P, CCA, RHIT, or RHIA) - highly preferred.TOTAL REWARDS AT VANOVA HEALTH SOLUTIONS:At Vanova, we see Total Rewards as more than just a paycheckand recognize that value comes in many forms. It is the full experience of being a part of ourincredibleteamworking toward a shared, mission-driven purpose.We’reproud to offer competitive compensation, health and wellness benefits,a retirement savings plan, time offto recharge, learning opportunities to continuallygrow,andmeaningful workin acollaborativeculturethat fosters team connection through shared celebrations and appreciation events.We are committed to investing in the future of our people and focused on expanding our total rewards to support every stage of your journey with us.Theanticipatedpayrange for this role is:$23/hr-$25/hrThisposition offersan opportunity forannualtarget bonus basedon individual performance and company financial performance.Comprehensive benefitsbased on eligibilityinclude a401K retirement savings planwith company match,paid time off, and health benefits (medical, prescription drug, dental and vision insurance).Please note that individual total compensation for this position will bedeterminedat theCompany’s sole discretion and may vary based on several factors, including but not limited tolocation, skill level, years and depth of relevant experience, and education.EEOC Statement: Vanova Health is an Equal Opportunity Employer. We are committed to creating adiverse and inclusive environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.This job description is intended to describe the general nature and level of work performed and is not an exhaustive list of all responsibilities, duties, and skills associated with it. Duties and expectations may be subject to change with or without notice.#LI DNI

Created: 2026-03-02