ZipRecruiter

Log In

1

From Home Hcc Risk Adjustment Coder Jobs in Elgin, IL

Bcbsa

Head of Medicare Performance Hub

Chicago, IL · On-site

... from local Plan responsibilities - and ensure alignment across all stakeholders Plan Engagement ... CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization ...

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 · 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 · 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 ...

Bcbsa

Medicare Plan Management Principal

Chicago, IL · Hybrid

The role will build and steward the full lifecycle of plan relations: from go-to-market planning ... Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP ...

next page

Showing results 1-20

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 Aug 29, 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 is a from home HCC risk adjustment coder?

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.

What are the key skills and qualifications needed to thrive as a from home HCC risk adjustment coder?

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.

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.

What are popular job titles related to From Home Hcc Risk Adjustment Coder jobs in Elgin, IL?

For From Home Hcc Risk Adjustment Coder jobs in Elgin, IL, the most frequently searched job titles are:

What job categories do people searching From Home Hcc Risk Adjustment Coder jobs in Elgin, IL look for?

The top searched job categories for From Home Hcc Risk Adjustment Coder jobs in Elgin, IL are:

What cities near Elgin, IL are hiring for From Home Hcc Risk Adjustment Coder jobs?

Cities near Elgin, IL with the most From Home Hcc Risk Adjustment Coder job openings:

From Home Hcc Risk Adjustment Coder jobs near you

Senior Manager, Corporate Compliance - Risk Adjustment

Northbrook, IL

CVS Health
Health Care and Social Assistance • 10K+ employees

5.8

Company rating: 5.8 out of 10

Based on 4,353 frontline employees who took The Breakroom Quiz

91st of 113 rated pharmacies

Recommended by students

Recommended by parents

Respectful managers

Learn more about CVS Healthexternal

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 7 days ago

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.

What CVS Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply