Location:

Lecanto, Hybrid Remote The Role We are seeking a HCC Coder to join our Primary Care team! This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance with CMS guidelines while supporting high-quality patient outcomes. You will be responsible for reviewing medical records, identifying appropriate HCC diagnoses, ensuring documentation integrity, and collaborating closely with providers and clinical teams to optimize RAF scores and coding accuracy.

What You'll Do:

Conduct pre-visit and chart reviews to identify known and suspected RAF/HCC conditions prior to patient appointments Conduct post-visit chart reviews to ensure all RAF/HCC opportunities have been captured by the medical provider prior to claims submission/billing Conduct post claims submission reconciliation from payer to ensure all codes have been properly accounted for through files such as MOA004, MOR and MMR Review provider documentation and assign accurate ICD-10 and HCC codes Identify documentation gaps and provide clear, actionable feedback to providers Track coding trends and identify performance improvement opportunities Collaborate closely with Clinical Integrity, Outreach, and Provider Teams Maintain established productivity and quality benchmarks Stay current with CMS risk adjustment guidelines and regulatory updates Requirements Minimum 2+ years of HCC/Risk Adjustment coding experience (required) Knowledge of CMS risk adjustment methodology and Medicare Advantage models Active coding credential preferred (CRC, CPC, CCS, or equivalent) Proven experience with chart audits and provider education Experience performing pre and post -visit RAF reviews preferred Analytical skills and attention to detail Experience with EHR systems required Value-based care experience preferred Employer conducts background checks.

Benefits Available To You:

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

Work Schedule :

Full time,

Hybrid Remote Salary:

DOE All employment offers at PedIM Healthcare are contingent upon the successful completion of applicable background checks, verification of credentials, and compliance with health and safety requirements. Compliance & Equal Opportunity Notice PedIM Healthcare is proud to be an Equal Opportunity Employer and is fully committed to compliance with all federal, state, and local employment laws. We believe every team member deserves a workplace built on respect, fairness, and opportunity.

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

In alignment with the Americans with Disabilities Act (ADA), PedIM Healthcare provides reasonable accommodations to qualified individuals with disabilities to ensure equal access to employment opportunities and participation in all aspects of our hiring and employment processes. Employment at PedIM Healthcare is offered on an at-will basis and is contingent upon the successful completion of all required background checks, credential verifications, and health or safety screenings consistent with healthcare regulatory standards. Certain roles may also require proof of immunizations or other health compliance documentation. We are dedicated to fostering a diverse, inclusive environment where every employee feels valued, supported, and empowered to contribute to our mission of delivering exceptional, compassionate care to our community. 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