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From Home Hcc Risk Adjustment Coder Jobs in Elgin, IL

Strive Health

Nurse Practitioner

Chicago, IL · On-site

Hybrid-Remote Flexibility -Work from home while fulfilling in-person needs at the office, clinic ... Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and ...

Strive Health

Nurse Practitioner

Chicago, IL

$120K - $151K/yr

... their homes and via telehealth. In this role, you will harness the power of advanced analytics ... Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and ...

Rush University Medical Center

HIM Coder

Chicago, IL · Remote

$29.36 - $47.79/hr

... from-home space Ability to apply local, state, and federal coding guidelines with attention to detail. Responsibilities: • Assigns ICD-10-CM-PCS and/or CPT-4 diagnostic and procedure codes to ...

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All JobsHcc Risk Adjustment Coder JobsFrom Home Hcc Risk Adjustment Coder JobsFrom Home Hcc Risk Adjustment Coder Jobs in Elgin, IL

From Home Hcc Risk Adjustment Coder information

See Elgin, IL salary details

$15

$27

$43

How much do from home hcc risk adjustment coder jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for from home hcc risk adjustment coder in Elgin, IL is $27.18, according to ZipRecruiter salary data. Most workers in this role earn between $18.75 and $34.23 per hour, depending on experience, location, and employer.

What are From Home HCC Risk Adjustment Coders?

From Home HCC Risk Adjustment Coders are health information professionals who work remotely to review medical records and assign appropriate codes based on Hierarchical Condition Categories (HCC) for risk adjustment purposes. Their work ensures that healthcare providers receive accurate reimbursement from insurance companies, particularly Medicare Advantage plans. These coders must have a strong understanding of ICD-10-CM coding guidelines, clinical documentation, and risk adjustment models. Working from home allows for flexibility, but still requires strict attention to detail and adherence to privacy regulations.

Is HCC coding a good career?

HCC coding is a growing field within healthcare revenue cycle management, focusing on risk adjustment for insurance purposes. It requires attention to detail, knowledge of medical coding, and often involves remote work with certification in medical coding or risk adjustment. Many find it to be a stable and in-demand career option with opportunities for advancement.

What are some common challenges faced by From Home HCC Risk Adjustment Coders, and how can they be managed?

From Home HCC Risk Adjustment Coders often face challenges such as interpreting complex medical records, staying updated with evolving coding guidelines, and managing productivity without in-person supervision. To overcome these, coders should prioritize ongoing education, use reliable coding resources, and maintain clear communication with their remote team. Setting a structured daily routine and participating in virtual team check-ins can also help maintain focus and ensure consistent quality in code assignments.

How much does a certified risk adjustment coder make?

A certified risk adjustment coder typically earns between $50,000 and $80,000 annually, depending on experience, certification level, and geographic location. Experienced coders with advanced certifications and strong knowledge of coding and medical records can earn higher salaries, especially in healthcare settings with complex risk adjustment programs.

How much do risk adjustment coders make?

Risk adjustment coders typically earn between $50,000 and $75,000 annually, depending on experience, certifications, and location. In Texas, salaries generally align with this range, with some positions offering higher pay for specialized skills or remote work opportunities.

How much do HCC coders make in the US?

HCC (Hierarchical Condition Category) risk adjustment coders in the US typically earn between $50,000 and $80,000 annually, depending on experience, certification, and location. Experienced coders with certifications like CPC or CCS and strong knowledge of medical coding and risk adjustment principles can earn higher salaries, especially in healthcare hubs or remote work environments.

What are the key skills and qualifications needed to thrive as a From Home HCC Risk Adjustment Coder, and why are they important?

To thrive as a From Home HCC Risk Adjustment Coder, you need a thorough understanding of ICD-10-CM coding, risk adjustment models, and medical terminology, usually backed by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic health record (EHR) systems, coding software, and secure remote work platforms is essential. Strong attention to detail, time management, and self-motivation are vital soft skills for ensuring accuracy and productivity while working independently. These skills are crucial for maintaining compliance, optimizing reimbursement, and ensuring data integrity in a remote environment.
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From Home Hcc Risk Adjustment Coder jobs near you

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Northbrook, IL

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,322 frontline employees who took The Breakroom Quiz

87th of 109 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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