HCC Medical Coder

Join the Team at PedIM Healthcare!

Delivering exceptional care, together.

Who We Are

PedIM Healthcare is a pioneering medical office offering top-quality care for children, adults, and seniors all under one roof. Our compassionate team focuses on pediatrics, internal medicine, family practice, geriatrics, women’s care, medical weight loss, sleep medicine services, and more.

Why Work With Us?

• A diverse practice allowing growth across pediatrics, internal medicine, weight-loss, and sleep medicine specialties.
• A workplace rooted in values: we listen, help, understand, and care.
• Acknowledged as the best in the region for community-oriented care.
• An opportunity to make a significant impact on the health journeys of patients from children to seniors.
• A commitment to employee development and holistic patient care.

The Role

We are looking for a dedicated and proactive HCC Coder to join our Primary Care team!

In this essential position, you will play a vital role in ensuring precise risk adjustment, thorough documentation, and compliance with CMS guidelines while contributing to high-quality patient care. Your responsibilities will include reviewing medical records, identifying appropriate HCC diagnoses, maintaining documentation integrity, and closely collaborating with providers and clinical teams to optimize RAF scores and coding accuracy.

What You'll Do:

• Conduct pre-visit and chart reviews to identify RAF/HCC conditions before patient appointments.
• Perform post-visit chart reviews to ensure all RAF/HCC opportunities are captured by the medical provider before claims submission.
• Carry out post-claims submission reconciliation to ensure accurate coding with payers.
• Review provider documentation and assign precise ICD-10 and HCC codes.
• Identify documentation gaps and offer constructive feedback to providers.
• Monitor coding trends and identify areas for performance improvement.
• Collaborate closely with Clinical Integrity, Outreach, and Provider Teams.
• Maintain established productivity and quality standards.
• Stay informed on CMS risk adjustment guidelines and regulatory updates.

Qualities That Make You A Great Fit:

• At least 2 years of experience in HCC/Risk Adjustment coding.
• Strong knowledge of CMS risk adjustment methodology and Medicare Advantage models.
• Active coding credential preferred (CRC, CPC, CCS, or equivalent).
• Demonstrated experience in chart audits and provider education.
• Experience with pre and post-visit RAF reviews preferred.
• Strong analytical skills and attention to detail.
• Proficiency with EHR systems required.
• Value-based care experience strongly preferred.

Benefits Available To You:

Joining our team means more than just a job—it offers access to benefits designed to support your health, well-being, and work-life balance.

• Health coverage and Sick-N-Well membership.
• Health Savings Account (HSA).
• Life insurance.
• Paid time off.
• 401(k) plan with a 4% company match.
• Relax Scofa membership.
• Employee Assistance Program (EAP).
• Employee Recognition Program.
• And more!

All employment offers at PedIM Healthcare are contingent upon the successful completion of background checks, credential verification, and compliance with health and safety requirements.

Compliance & Equal Opportunity Notice

PedIM Healthcare is proud to be an Equal Opportunity Employer, committed to compliance with all employment laws. We believe every team member deserves a respectful and fair workplace.

We do not discriminate based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, marital status, veteran status, or any other protected characteristic under applicable law.

In line with the Americans with Disabilities Act (ADA), we provide reasonable accommodations to qualified individuals with disabilities to ensure equal access to employment opportunities.

Employment at PedIM Healthcare is offered on an at-will basis, contingent on successful completion of all required checks, verifications, and health compliance documentation.

We are dedicated to promoting a diverse, inclusive environment where all employees feel valued and empowered to deliver exceptional care.

EOE

PM20

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