HCC Coding Specialist

This role delivers value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage and the Affordable Care Act by performing accurate Hierarchical Condition Category (HCC) coding. The position involves analyzing physician documentation, interpreting diagnoses into ICD10 codes, and supporting Risk Adjustment Data Validation audits to ensure compliance with CMS requirements. The specialist collaborates with physicians and internal teams to drive documentation improvement and process efficiencies.