HCC Coding Educator - Physician Education

Hcc Coding Educator

The Hcc Coding Educator is responsible for improving the accuracy, completeness, and compliance of risk-adjustment documentation through targeted provider education, documentation review, and performance monitoring. This role supports Medicare Advantage, ACO, and other risk-based contracts by ensuring Hierarchical Condition Category (Hcc) capture accurately reflects patient acuity while remaining fully compliant with CMS and payer audit standards. The position serves as a clinical documentation and coding subject-matter expert, partnering with providers, care management teams, and compliance leadership to optimize risk adjustment outcomes and reduce audit exposure.

Education: Associates degree in health information management, nursing, healthcare administration or related field required.

Experience: Minimum of 3 years experience in Hcc coding and risk adjustment. Minimum of 3 years experience in Medicare Advantage, MSSP, ACO or other value-based care models. Demonstrated experience providing provider education or coding feedback. Experience reviewing outpatient clinical documentation for risk adjustment.

Certification: CRC, CPC, CCS, COC, RHIA or RHIT required.

License: N/A