Elizabeth Hernandez
Risk Adjustment & HCC Coder | RHIT, CCS Certified | ICD-10-CM | Medicare Advantage | CMS Guidelines | RAF Accuracy | Documentation Integrity
- Role
- Hcc Coding Specialist at Virtix Health
- Location
- Neenah, WI, US
- LinkedIn followers
- 500 followers
About Elizabeth Hernandez
As an HCC Risk Adjustment Coder holding RHIT and CCS credentials, I specialize in accurate ICD-10-CM coding, CMS-HCC model application, and comprehensive clinical documentation review to ensure proper capture of patient complexity and risk scores (RAF).With a strong foundation in Health Information Management, I focus on Medicare Advantage risk adjustment, hierarchical condition category (HCC) coding, and compliance with CMS guidelines. I am experienced in reviewing medical records to validate diagnoses, identify documentation gaps, and support accurate reimbursement and quality reporting.My expertise includes:• HCC & Risk Adjustment Coding• ICD-10-CM Guidelines & Official Coding Rules• CMS-HCC Model & RAF Accuracy• Medicare Advantage• Clinical Documentation Improvement (CDI) Collaboration• Coding Compliance & Audit Readiness• Chronic Condition Capture & Suspect Review• Reimbursement IntegrityI am detail-oriented, analytical, and committed to documentation integrity, regulatory compliance, and continuous professional growth. My goal is to contribute to organizations focused on value-based care, accurate risk stratification, and ethical coding practices.
Experience
Hcc Coding Specialist
Oct 2024 — Present · US
Perform chart review analysis for risk adjustment on Outpatient and Inpatient charts - Utilize advanced coding software, including AI and NLP processing tools to improve accuracy and efficiency - Use (T.A.M.P.E.R) to assist in proper coding of diagnoses requiring support - Assign appropriate ICD-10 codes that map to risk adjustment models
Education
Fox Valley Technical College
Associate's degree, Health Information/Medical Records Technology/Technician
Southwest Wisconsin Technical College
Associate of Applied Science - AAS, Cancer Information Management
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