Risk Adjustment Coding Coordinator (onsite), full time, days
Holland Hospital
Coordinator
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.
Qualifications: Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hire Experience with risk adjustment programs preferred. Prior provider education or clinical collaboration experience preferred. Excellent communication skills for provider education and stakeholder collaboration
Employment Type: Full Time
Shift: Mon-Thrs- 8am-4:30pm Fri- 8a-12p
Weekly Scheduled Hours: 36
Weekend Requirements: NA
Requirements:
- High school diploma/GED or higher education
-Certified Professional Coder (C-CPC)
Clinical Documentation Review & Risk Adjustment Coding
- Prepare and manage risk adjustment visit workflows, including maintaining patient lists, diagnosis summaries, and assisting with scheduling coordination.
- Conduct comprehensive pre‑visit chart reviews to identify and validate ICD‑10-CM diagnoses that accurately represent each patient's health status.
- Perform post‑visit documentation analysis to ensure proper ICD‑10-CM code assignment, diagnosis specificity, and compliance with MEAT (Monitor, Evaluate, Assess, Treat) criteria.
- Maintain up‑to‑date knowledge of CMS risk adjustment regulations, HCC models, and clinical documentation and coding standards.
- Support organizational value-based care goals by collaborating with Manager, Quality and clinical teams to ensure compliant risk adjustment documentation.
Provider Engagement, Education & Clinical Support
- Serve as a clinical documentation and coding subject matter expert, supporting providers in achieving compliant and accurate risk adjustment practices.
- Deliver ongoing education and feedback to providers and coders regarding documentation standards, diagnosis specificity, and optimal risk adjustment coding principles.
- Identify documentation gaps or inconsistencies and communicate findings through structured, actionable feedback, including formalized documentation queries as needed.
- Promote a culture of documentation excellence that supports quality outcomes, operational performance, and compliant value-based care delivery.
Audit, Reporting & Performance Monitoring
- Conduct routine and targeted chart audits to assess documentation quality, coding accuracy, and HCC recapture performance.
- Track, analyze, and report key risk adjustment performance indicators, including recapture rates, suspect condition closure, documentation accuracy, and provider-level trends.
- Collaborate with operational leaders to integrate risk adjustment best practices into existing clinical workflows and identify opportunities for process improvement.
- Participate in quality assurance initiatives, report findings to leadership, and support the development of corrective action plans or workflow enhancements.
Holland Hospital is an Equal Opportunity Employer, please see our EEO policy
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