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Value Based Coder II

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American Nursing Care

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Location:
United States , Houston

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Category:
IT - Administration

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Contract Type:
Not provided

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Salary:

25.30 - 35.74 USD / Hour
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Job Description:

The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement.

Job Responsibility:

  • Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC
  • Validate the accuracy and completeness of HCC documentation and coding
  • Advanced Documentation Improvement & Education: Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture
  • Develop and deliver effective education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture
  • Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles
  • Compliance & Regulatory Insight: Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education efforts
  • Champion a culture of compliance by advocating for best practices and providing robust provider support to ensure CommonSpirit adheres to all federal and coding guidelines pertaining to HCC and risk adjustment
  • Safeguard medical records and preserve the confidentiality of personal health information through adherence to all relevant policies
  • Process Improvement & Collaboration: Actively participate in network performance improvement initiatives, offering insights and solutions based on coding expertise
  • Collaborate with providers and office staff to address documentation deficiencies and coding gaps

Requirements:

  • Bachelor’s degree in healthcare or equivalent work experience and/or 5 years of related job or industry experience in lieu of degree
  • Certified Professional Coder (CPC) from AAPC, OR Certified Coding Specialist (CCS) from AHIMA, OR Certified Risk Adjustment Coder (CRC) from AAPC
  • 2+ years of experience in outpatient coding
  • 2+ years focused on risk adjustment and HCC principles
  • Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC coding guidelines and risk adjustment models
  • Strong understanding of federal and state guidelines on all coding systems and sponsored programs
  • Proficiency in developing and delivering educational content
  • Effective interpersonal, communication, and presentation skills (both verbal and written)
  • Ability to manage multiple priorities and work independently
  • Computer literacy in medical information systems, records management software, and encoder software
What we offer:
  • medical
  • prescription drug
  • dental
  • vision plans
  • life insurance
  • paid time off
  • tuition reimbursement
  • retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

Additional Information:

Job Posted:
February 19, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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