HCC Coder Job Description Template
The HCC Coder is responsible for reviewing, analyzing, and coding diagnostic information in medical records. This role ensures accurate coding for risk adjustment, compliance, and reimbursement purposes. The coder must adhere to all coding guidelines and corporate policies while maintaining the highest quality standards.
Responsibilities
- Review and analyze medical records to ensure proper HCC coding
- Abstract and code diagnoses using ICD-10 CM codes
- Ensure coding compliance with federal and state regulations
- Maintain documentation to support coding accuracy
- Collaborate with healthcare providers to clarify diagnostic information
- Conduct regular audits to ensure coding accuracy and compliance
- Participate in continuous education and training programs
Qualifications
- Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) credential
- 2+ years of experience in HCC coding
- Comprehensive understanding of ICD-10 CM coding guidelines
- Familiarity with medical terminology and healthcare systems
- Strong analytical and organizational skills
- Excellent verbal and written communication abilities
Skills
- ICD-10 CM
- HCC Coding
- Medical Terminology
- Risk Adjustment
- EHR Systems
- Compliance Auditing
- Data Entry
- Attention to Detail
Frequently Asked Questions
An HCC Coder is responsible for evaluating medical records and translating them into specific ICD-10-CM codes using the Hierarchical Condition Category (HCC) methodology. This role ensures accurate risk adjustment coding for healthcare plans, which is crucial for proper patient risk assessments and reimbursement purposes. HCC Coders must pay close attention to detail and adhere to coding regulations while reviewing patient information.
To become a certified HCC Coder, individuals should first obtain a certification such as the Certified Risk Adjustment Coder (CRC) from the AAPC. This typically requires medical coding experience and passing a certification exam. Many employers prefer candidates with formal training in healthcare coding, which includes familiarity with ICD-10 coding systems. Continuous education and staying updated with coding changes are also essential for success.
The average salary for an HCC Coder varies based on experience, location, and certifications. Typically, experienced coders with specialized credentials in the healthcare sector earn a higher salary. HCC Coders may also find opportunities for salary advancement through gaining more experience, certifications, and specialization, particularly in risk adjustment strategies within a healthcare organization.
Qualifications for an HCC Coder role often include a high school diploma or equivalent, though further education such as an associate degree in medical coding or health information management is beneficial. Certification in risk adjustment coding, such as CRC, is typically required. A strong understanding of ICD-10 coding, medical terminology, and healthcare compliance is critical, along with proficient analytical skills and attention to detail.
An HCC Coder must have a keen understanding of medical coding guidelines, particularly ICD-10-CM and HCC methodology. They are responsible for reviewing medical records, ensuring precise documentation and coding. Strong analytical skills, attention to detail, and the ability to work with electronic health records are essential. They must also remain compliant with healthcare regulations and coding standards while regularly updating their knowledge of coding practices.