Demo

HCC Coder

To Help Everyone Health & Wellness Centers
Los Angeles, CA Full Time
POSTED ON 12/12/2025
AVAILABLE BEFORE 2/11/2026
South Los Angeles based FQHC looking for onsite Certified HCC coder .*This is not a remote positionConduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare RiskAdjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding.Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records auditHEDIS coding and record collectionReport Coding discrepancies patterns identified within the chart review process to the Coding Project Manager and identify corrective measures regarding compliance problems, and suggests corrective measure to the physician in understanding of what is needed regarding documentation complianceProvider EducationProvide detailed summary to make adjustments to correct improperly paid claims and document the correct coding to be utilizedManagement Feedback:Communicate quality issues to direct supervisor & COO, Team Leaders and other Managers.Provide recommendations to management based on audit findingsManagement reports:Prepare management summary reports of audit findingsAdditional Responsibilities:Provide support to the Management as required.Maintains detailed knowledge of coding guidelines and regulationsQualification Experience and Skills Required Experience:Must have CPC or CCS certificationFive (5) years coding experience.Multi-Specialty coding experienced required.Outpatient/Clinic billing experience required.Physician billing office supervisory experience preferredKnowledgeable in Hierarchical Condition Categories (HCC) concepts and documentation guidelines.Knowledge in MACRA reportingHigh School degree required. Some college preferred.Company DescriptionT.H.E. Health and Wellness Centers is a nonprofit community clinic in South Los Angeles. For more than 50 years, we've provided high-quality, low cost healthcare and preventative education for all.We are an Equal Opportunity Employer.

Salary : $28 - $32

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