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Full Time Optum Hcc Coding Jobs (NOW HIRING)

St Luke's Health

$25.30 - $35.74/hr

Preferred/Desired Experience 4+ years of experience in outpatient coding, 3+ years focused on risk adjustment and HCC principles Employment Type: Full Time

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Full Time Optum Hcc Coding information

What is the difference between Full Time Optum Hcc Coding vs Full Time Medical Coder?

AspectFull Time Optum Hcc CodingFull Time Medical Coder
CertificationsAHIMA/ACM certifications, HCC coding credentialsAHIMA/ACM certifications, CPC or CCS certifications
Work EnvironmentInsurance, healthcare analytics, risk adjustment teamsHospitals, clinics, physician offices
Industry UsageHealth insurance, risk adjustment, Medicare AdvantageHealthcare providers, billing departments

Full Time Optum Hcc Coding specialists focus on risk adjustment and insurance data, often working in insurance companies or analytics teams. Full Time Medical Coders typically work in healthcare facilities, translating medical records into billing codes. While both roles require coding certifications, HCC coders emphasize risk and insurance data, whereas medical coders focus on clinical documentation and billing.

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Full Time Optum Hcc Coding jobs near you
Infographic showing various Full Time Optum Hcc Coding job openings in the United States as of July 2026, with employment types broken down into 85% Full Time, 11% Part Time, 1% Temporary, and 3% Contract. Highlights an 79% Physical, 4% Hybrid, and 17% Remote job distribution.
ACO Risk Coding Specialist (Hybrid)

ACO Risk Coding Specialist (Hybrid)

Essen Medical Associates

Bronx, NY

$27/hr

Full-time

Re-posted 10 days ago

Essen Health Care rating

3.3

Company rating: 3.3 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.


The risk coding specialist will help providers to implement coding guidelines and properly document the disease burden of their patients. They will become experts in HCC-based risk adjustment (prior experience preferred, but not necessary), they will conduct medical chart reviews to identify suspect conditions, and they will design and manage workflows to ensure that providers are made aware of suspect conditions, so that they can evaluate the patient thoroughly and correctly document the patient’s risk factors.


- Learn the details risk coding and adjustment. What are the categories of diseases that matter, and what are the criteria required for (a) surfacing, (b) proving, and (c) documenting a particular condition.

- Oversee an offshore team in conducting risk coding activities

- Conduct chart reviews to identify suspect conditions and highlight inadequately coded progress notes.

- Design workflows to notify doctors of suspect conditions.

- Ensure incoming labs and diagnostic imaging results relevant to risk adjustment are brought to provider’s attention.

- Education providers on proper documentation and coding guidelines.

- Suggest improvements to team workflows to ensure maximum coding integrity.


Qualifications:
- Strong working knowledge of CMSHCC risk adjustment model (required for accurate coding and compliance)
- Solid understanding of ICD10CM coding guidelines
- Ability to accurately identify and code chronic conditions requiring annual recapture
- Experience reviewing facetoface encounters and validating provider documentation
- Skilled in retrospective and/or prospective chart reviews
- Experience with provider education or documentation improvement initiatives
 
Knowledge, Skills, & Abilities:
- Deep understanding of chronic disease processes (e.g., CHF, CKD, COPD, diabetes with complications)
- Familiarity with hierarchical logic and exclusion rules in HCC coding
- Strong analytical, organizational, and problemsolving skills, especially in Excel
- Ability to research and resolve coding discrepancies independently
- Effective written and verbal communication with clinical and nonclinical staff
- Team-based orientation with ability to manage and report out KPIs
- Cultural sensitivity and ability to work with diverse team members, both US-based and offshore, and with medical providers
- Consistent ability to meet productivity and quality benchmarks
 
Education:
- High School Diploma or equivalent (required)
- International Medical Graduate (preferred)
- Certified Risk Adjustment Coder (CRC)
- Certified Professional Coder (CPC) or CCS / RHIT / RHIA (AAPC or AHIMA)
 

Compensation & Benefits

· Pay: $27/hr base, some OT available, performance-based bonuses

· Job Type: Full-time


Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

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