HCC Online Courses: Flexible HCC Course Learning Options

Module 1 – Risk Adjustment Essentials & RAF Math

This module explains risk adjustment principles and how RAF scores are calculated. Learners understand how diagnoses affect reimbursement and patient complexity.

Module 2 – ICD-10-CM for HCC High-Value Condition Families

Learners focus on high-impact HCC diagnosis categories and coding specificity. The module strengthens accurate condition capture and hierarchy logic.

Module 3 – Documentation Standards MEAT, Problem Lists & Queries

This module covers MEAT criteria and compliant documentation practices. Learners develop effective query skills to support valid code assignment.

Module 4 – Visit Strategy Annual Wellness, Chronic Care & Telehealth

Learners explore visit planning for HCC capture across care settings. The module explains how wellness visits and telehealth support risk adjustment.

Module 5 – Social Determinants & Non-HCC Codes That Change Care

This module explains the importance of social determinants and related codes. Learners understand how these factors influence care quality and outcomes.

Module 6 – Payer Nuances, Edits & RA Data Integrity

Learners examine payer-specific rules and common risk adjustment edits. The focus is on maintaining data accuracy and compliance.

Module 7 – RADV, Compliance & Audit-Proof Coding

This module prepares learners for RADV audits and regulatory reviews. It emphasises defensible coding and documentation practices.

Module 8 – Denials, Appeals & Provider Education

Learners gain skills in managing denials and preparing appeals. The module also covers educating providers on documentation improvement.

Module 9 – Analytics, Suspecting & Performance Dashboards

This module introduces suspecting models and performance tracking tools. Learners use analytics to improve risk capture and reporting accuracy.

Completing the Medical Billing Risk Adjustment (HCC) Advanced Diploma opens career opportunities such as Risk Adjustment Coder, HCC Auditor, RAF Analyst, CDI Specialist, Compliance Analyst, or Healthcare Data Analyst. Graduates may work with Medicare Advantage plans, healthcare organisations, revenue cycle vendors, or consulting firms. This qualification also supports progression into leadership roles in risk adjustment operations, audit management, and value-based care analytics.

Upon successful completion of the Medical Billing Risk Adjustment (HCC) Advanced Diploma, candidates will have two certificate options to choose from:

Option 1: Certificate Issued by the Quality Licence Scheme (QLS)

This certificate is issued by the Quality License Scheme, confirming that the course meets high-quality education standards. It is ideal for learners who wish to showcase their formal completion of a professionally developed training program.

Option 2: Accredited CPD Certificate Issued by the CPD Standards Office

Candidates also have the option to claim a Continuing Professional Development (CPD) certificate, accredited by the CPD Standards Office. This internationally recognized certificate is particularly suitable for professionals who want to demonstrate their commitment to ongoing development and enhance their CPD records.

Both certificates offer valuable recognition and can strengthen your professional profile across a range of industries.

What programming language is used in this course?
This course does not involve programming and focuses on medical coding, documentation, and risk adjustment processes.

Do I need prior knowledge of machine learning?
No technical background is required, but prior experience in medical coding is beneficial.

Can I complete this course at my own pace?
Yes, this programme is fully self-paced and designed for flexible home study.

What is risk adjustment in HCC coding?
It is a method used to reflect patient health complexity through diagnosis coding.

What is risk adjustment in medical billing?
Risk adjustment ensures accurate reimbursement by matching payments to patient conditions.