HCC Risk Adjustment Coder

Overview

At
Vista Community Clinic (VCC), we believe healthcare is more than medicine, it’s about hope, community, and impact. For over 50 years, we’ve been a leader in the community clinic movement, growing from a small volunteer-driven effort in Vista to a nationally recognized network of state‑of‑the‑art clinics across San Diego, Orange, Los Angeles, and Riverside counties. Today VCC has 14 clinics serving over 70,000 patients annually, we continue our mission of delivering exceptional, patient‑centered care where it’s needed most.

As a private, non‑profit, multi‑specialty outpatient clinic, VCC provides more than healthcare, we provide opportunity. Here your skills are celebrated, your growth is supported and your work makes a difference. We know that our success is a direct result of the exceptional talents and dedication of our employees.

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Benefits include:✅ Competitive compensation & benefits✅ Medical, dental, vision✅ Company‑paid life insurance✅ Flexible spending accounts✅ 403(b) retirement plan

• 🏅 Winner of 2025 HRSA Gold Medal for Outstanding Care, placing VCC among the top 10% of Federally Qualified Health Centers in the U.S.

• Recognized by HRSA as a National Quality Leader in Behavioral Health and Diabetes and for excellence in Preventive Health and Health IT.

• A robust training & development culture to help you grow and advance your career.

• A workplace built on respect, collaboration and passion for care.

• Perform PACE coding and auditing, working with clinicians on documentation and work flows as needed
• Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment
• and HCC coding guidelines
• Ensure coding is consistent with ICD‑10‑CM, CMS‑HCC, and other relevant coding guidelines
• Validate and ensure the completeness, accuracy and integrity of coded data
• Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding
• Stay up to date with the latest coding guidelines, rules and regulations related to Risk Adjustment and HCC coding
• Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality
• Collaborate with healthcare providers, physicians and other team members to clarify documentation and resolve coding queries
• Participate in coding education and training programs to enhance coding skills and knowledge
• Prepare and submit reports related to coding activities, coding accuracy, and any coding‑related issues or trends
• Assist in internal and external coding audits to ensure the quality and compliance of coding practices
• Identify opportunities for process improvement and efficiency in the coding process
• Offer suggestions to enhance coding documentation and accuracy
• Review documentation of every Annual Health Assessment in the Medical Record and Medical Diagnosis Report (MDX) to ensure accurate codes and documentation are applied to the encounter for billing
• Utilize available encoder, software and other coding resources to determine the appropriate ICD‑10‑CM diagnosis codes mapped to HCCs
• All additional tasks assigned with respect to medical coding and assisting Revenue Cycle staff and Operations on coding questions, issues and updates that may arise
• Enhance professional growth and development through participation in educational programs, current literature review, in¬ service meetings and workshops
• Support the vision, mission and goals, and demonstrate a commitment to the values, of the organization
• Perform other duties as directed

• High school graduate or equivalent
• AAPC Coding certification
• Minimum three years’ medical billing experience
• Minimum two years’ medical coding experience

• Two years’ experience in an FQHC environment
• Experience with Next Gen
• Experience in coding compliance program implementation

Required Skills/Knowledge/Abilities

• Knowledge of Medicare, Medi‑Cal/Presumptive Eligibility, FPACT, Every Woman Counts, Tricare and Managed Care Payors
• Ability and willingness to be flexible with schedule and work hours
• Knowledge of payer coding policies and guidelines for FQHC's
• Familiar with medical terminology
• Experi…