Medical Coding - Baystate Health

Req#: R31533
Category(s): Information Technology/Health Information Management, Medical Coding
Full Time / Part Time: Full-Time
Shift: First

Outpatient Risk Adjustment Coder 

•    Monday – Friday
•    No weekends no holidays

•    Springfield, MA 

Excellent Compensation High-quality, low-cost medical, dental and vision insurance
Generous PTO – up to 25 days in the first year, with scheduled earned increases
Continuing education support and reimbursement
First Time Home Buyers Financial Packages
Farm Share Memberships
403b retirement company match & annual company contribution increase based on years of service
Free money coach advice from a certified professional
Wellbeing programs that include but are not limited to mental, physical, and financial health
Pet, home, auto and personal insurance
Life insurance
Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!
Wellbeing programs that include but are not limited to mental, physical, and financial health
Baystate Health, western Massachusetts’ only academic center and tertiary care provider has a long and proud tradition of continuous learning and improvement. We educate and train hundreds of healthcare workers every year and advance knowledge about new approaches to care. At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff.  We are committed to increasing diverse representation across our organization. Together our inspired and compassionate teams manage the whole health needs of all communities in need.  

The Outpatient Risk Adjustment Coder supports risk adjustment optimization activities that improve value-based care and population health by facilitating accurate capture of chronic conditions in the medical record,
collecting data around provider documentation and coding practices, and identifying opportunities to close care gaps. Working with the HCC Nurse Educator, the Ouptatient Risk Adjustment Coder conducts prospective chart reviews to ensure chronic conditions (HCCs) are listed in medical record before provider visits and uses ICD-10 CM coding guidelines and risk adjustment regulations to identify missed opportunities to address chronic conditions in retrospective chart reviews. Collects data during reviews and runs reports from the population health platform to identify areas to target for education and performance improvement. Works with primary care practice staff to schedule annual comprehensive visits. Assists with coordinating risk adjustment education and performance improvement projects. Assists with other activities and projects as assigned. Ideal candidate will have a strong knowledge of ICD-10 diagnosis coding and experience with risk adjustment or strong desire to learn. Clinical experience as an MA or LPN in an outpatient setting is helpful but not required.

  • Performs prospective chart reviews and updates EHR to prepare providers to address chronic conditions at future patient visits using established protocols, guidelines, and coding regulations. 
  • Identifies potential missed HCC documentation and coding opportunities through retrospective chart review; tracks and reports data to HCC Educator to help target education/workflow enhancement activities. 
  • Runs reports from population health analytics platform to guide education and performance improvement activities. 
  • Helps coordinate and facilitate large scale HCC Coding education initiatives and performance improvement projects. 
  • Engages in manual problem list updating projects that promote accurate documentation and coding, as well as accurate health registry data. 
  • Uses scheduling data to identify patients in need of annual comprehensive visits and works with primary care staff to schedule. 
  • Supports coding of social determinants of health through chart review and EHR updates. 
  • Working knowledge of CMS-HCC or Masshealth ACO risk model and willingness to learn unfamiliar risk adjustment models.

High School/GED and Nationally recognized Coding certification (such as CPC or CCS)

Preferred Education: Associate's Degree ; Certified Risk Adjustment Coder (CRC); Certified Documentation Expert Outpatient (CDEO); CMA or LPN

Required Experience: Required Experience: 
Minimum of 3 years in payor or healthcare coding position with exposure to risk adjustment/HCC coding, or combination of clinical experience in medical practice and medical coding. Prospective coding or risk adjustment coding; clinical experience in outpatient medical practice.

Preferred Experience:
Prospective coding or risk adjustment coding; clinical experience in outpatient medical practice.

We strive to be the place where we can help you build the career you deserve – apply today – YOU belong at Baystate!

We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.
For more information, please visit us online at: or interact with us socially at or on Twitter @BaystateCareers.

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.



Associate of Arts: Medical Terminology (Required)


Certified Coding Specialist – American Health Information Management Association

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

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