Aug 19, 2026

Risk Adjustment Coder Professional Billing II, FT, Days, - Remote

Job Description

Job TitleInspire health. Serve with compassion. Be the difference.Job SummaryConducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.Essential FunctionsAll team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.Conducts prospective review of charts to identify HCC opportunity.Conducts retrospective review of charts to confirm documentation supports reporting.Utilizes payor specific software to assist in capturing HCCs.Communicates with providers about HCC opportunities for improvement.Identifies suspect conditions that would potentially support reporting an HCC.Participates in education offeringsParticipates in monthly meetingsPerforms other duties as assigned.Supervisory/Management ResponsibilitiesThis is a non-management job that will report to a supervisor, manager, director or executive.Minimum RequirementsEducation - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferredExperience - Five (5) years professional fee coding experienceRequired Certifications, Registrations, LicensesCertified Professional Coder (CPC), andCertified Risk Adjustment Coder(CRC)Knowledge, Skills and AbilitiesKnowledge of office equipment (fax/copier)Proficient computer skills including word processing, spreadsheets, databaseData entry skillsMathematical skillsWork ShiftDay (United States of America)LocationPatewood Memorial HospitalFacility7002 Value-Based Care and Network ServicesDepartment70028459 HCC Coding ServicesShare your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.