... Coder preferred • Experience with Hierarchical Coding Category (HCC) Risk Adjustment Model preferred • HCC diagnosis coding and clinical record(s) review process preferred • Strong knowledge of ...
... Coder preferred • Experience with Hierarchical Coding Category (HCC) Risk Adjustment Model preferred • HCC diagnosis coding and clinical record(s) review process preferred • Strong knowledge of ...
Risk Adjustment Coding Specialist II - Remote
Monterey Park, CA · On-site +1
$70K - $85K/yr
Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs ... Certified Professional Coder (CPC) or CRC from AAPC * Certified Risk Adjustment Coder (CRC ...
Risk Adjustment Coding Specialist II - Remote
Monterey Park, CA · On-site +1
$70K - $85K/yr
Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs ... Certified Professional Coder (CPC) or CRC from AAPC * Certified Risk Adjustment Coder (CRC ...
Using primarily the Hierarchical Condition Category (HCC) Risk Adjustment model, conduct training ... Certified Professional Coder (CPC) required; Certified Risk Adjustment Coder (CRC) Required
Using primarily the Hierarchical Condition Category (HCC) Risk Adjustment model, conduct training ... Certified Professional Coder (CPC) required; Certified Risk Adjustment Coder (CRC) Required
Medicare Risk Adjustment Specialist - Medical Assistant
Jacksonville, FL · On-site
$16.50 - $20.75/hr
... Risk Adjustment Specialist. ESSENTIAL JOB FUNCTIONS: * Reviews medical record and claims ... HCC & HHS-HCC) models * Abstract all risk adjusted diagnosis codes from acceptable provider ...
Medicare Risk Adjustment Specialist - Medical Assistant
Jacksonville, FL · On-site
$16.50 - $20.75/hr
... Risk Adjustment Specialist. ESSENTIAL JOB FUNCTIONS: * Reviews medical record and claims ... HCC & HHS-HCC) models * Abstract all risk adjusted diagnosis codes from acceptable provider ...
Risk Adjustment Coder (On-site)
San Antonio, TX · On-site
$19.50 - $26/hr
This role focuses on the Risk Adjustment process that supports the documentation of acuity ... It assists with medical record reviews for HCC diagnoses, correct usage of various coding ...
Risk Adjustment Coder (On-site)
San Antonio, TX · On-site
$19.50 - $26/hr
This role focuses on the Risk Adjustment process that supports the documentation of acuity ... It assists with medical record reviews for HCC diagnoses, correct usage of various coding ...
Risk Adjustment Coder (On-site)
San Antonio, TX · On-site
$19.50 - $26/hr
This role focuses on the Risk Adjustment process that supports the documentation of acuity ... It assists with medical record reviews for HCC diagnoses, correct usage of various coding ...
Risk Adjustment Coder (On-site)
San Antonio, TX · On-site
$19.50 - $26/hr
This role focuses on the Risk Adjustment process that supports the documentation of acuity ... It assists with medical record reviews for HCC diagnoses, correct usage of various coding ...
Risk Adjustment Coding Specialist II - Orange County
Orange, CA · Remote
$70K - $85K/yr
Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience * Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage * Strong ...
Quick apply
Risk Adjustment Coding Specialist II - Orange County
Orange, CA · Remote
$70K - $85K/yr
Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience * Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage * Strong ...
Certified Coder (Risk Adjustment Experience) - REMOTE
Long Beach, CA · Remote
$24.50 - $33.50/hr
Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT ... Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. Background in ...
Certified Coder (Risk Adjustment Experience) - REMOTE
Long Beach, CA · Remote
$24.50 - $33.50/hr
Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT ... Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. Background in ...
Risk Adjustment Coding Auditor
Huntington Beach, CA · On-site +1
$28.50 - $32.25/hr
... HCC models, and medical necessity documentation requirements. · One of more of the following certifications are required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS ...
Risk Adjustment Coding Auditor
Huntington Beach, CA · On-site +1
$28.50 - $32.25/hr
... HCC models, and medical necessity documentation requirements. · One of more of the following certifications are required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS ...
Risk Adjustment Coding Specialist II - Remote
Monterey Park, CA · Remote
$70K - $85K/yr
Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs ... Certified Professional Coder (CPC) or CRC from AAPC * Certified Risk Adjustment Coder (CRC ...
Risk Adjustment Coding Specialist II - Remote
Monterey Park, CA · Remote
$70K - $85K/yr
Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs ... Certified Professional Coder (CPC) or CRC from AAPC * Certified Risk Adjustment Coder (CRC ...
Risk Adjustment Coding Specialist II - Remote
Monterey Park, CA · Remote
$70K - $85K/yr
Additionally, you'll track and report on key performance metrics--such as HCC recapture rates, AWVs ... Certified Professional Coder (CPC) or CRC from AAPC * Certified Risk Adjustment Coder (CRC ...
Quick apply
Risk Adjustment Coding Specialist II - Remote
Monterey Park, CA · Remote
$70K - $85K/yr
Additionally, you'll track and report on key performance metrics--such as HCC recapture rates, AWVs ... Certified Professional Coder (CPC) or CRC from AAPC * Certified Risk Adjustment Coder (CRC ...
Risk Adjustment Coding Auditor
Huntington Beach, CA · On-site
$72K - $80K/yr
... HCC models, and medical necessity documentation requirements. • One of more of the following certifications are required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS ...
Risk Adjustment Coding Auditor
Huntington Beach, CA · On-site
$72K - $80K/yr
... HCC models, and medical necessity documentation requirements. • One of more of the following certifications are required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS ...
ACO Risk Coding Specialist (Hybrid)
Bronx, NY · On-site
$27/hr
They will become experts in HCC-based risk adjustment (prior experience preferred, but not ... Coder (CRC) - Certified Professional Coder (CPC) or CCS / RHIT / RHIA (AAPC or AHIMA) Compensation ...
ACO Risk Coding Specialist (Hybrid)
Bronx, NY · On-site
$27/hr
They will become experts in HCC-based risk adjustment (prior experience preferred, but not ... Coder (CRC) - Certified Professional Coder (CPC) or CCS / RHIT / RHIA (AAPC or AHIMA) Compensation ...
Job Duties: * Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment * Meet department production and quality standards * Research regulatory guidelines for supporting ...
Quick apply
Job Duties: * Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment * Meet department production and quality standards * Research regulatory guidelines for supporting ...
PACE Risk Adjustment Coder
Salt Lake City, UT · On-site +1
Job Duties: * Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment * Meet department production and quality standards * Research regulatory guidelines for supporting ...
PACE Risk Adjustment Coder
Salt Lake City, UT · On-site +1
Job Duties: * Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment * Meet department production and quality standards * Research regulatory guidelines for supporting ...
Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid)
Los Angeles, CA · On-site
$208K/yr
Five or more years of experience with physician billing and/or coding * Three or more years of recent experience in CMS-HCC Risk Adjustment models V24 and V28 * Three or more years of experience in ...
Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment (Hybrid)
Los Angeles, CA · On-site
$208K/yr
Five or more years of experience with physician billing and/or coding * Three or more years of recent experience in CMS-HCC Risk Adjustment models V24 and V28 * Three or more years of experience in ...
Certified Coder (Risk Adjustment Experience) - REMOTE
Long Beach, CA · On-site +1
$17.85 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience) - REMOTE
Long Beach, CA · On-site +1
$17.85 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Remote Certified Coder
Dallas, TX · Remote
$22.25 - $30.50/hr
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...
Remote Certified Coder
Dallas, TX · Remote
$22.25 - $30.50/hr
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...
... Risk HRA/HCC Assessment forms, Medicare Advantage plans suspect HCC condition forms prior to ... Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) Visit us online at www.
... Risk HRA/HCC Assessment forms, Medicare Advantage plans suspect HCC condition forms prior to ... Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) Visit us online at www.
Certified Medical Coder
Houston, TX · On-site
$21.50 - $29.25/hr
Description Summary Certified Medical Coder role is responsible for reviewing, abstracting, and ... Risk Adjustment / HCC knowledge required * Managed Care experience preferred
Certified Medical Coder
Houston, TX · On-site
$21.50 - $29.25/hr
Description Summary Certified Medical Coder role is responsible for reviewing, abstracting, and ... Risk Adjustment / HCC knowledge required * Managed Care experience preferred
HCC Risk Adjustment Coder information
See salary details
$18.33 is the 25th percentile. Wages below this are outliers.
$15.87 - $18.38
26% of jobs
$18.38 - $20.89
9% of jobs
$20.89 - $23.40
12% of jobs
The median wage is $24.66 / hr.
$23.40 - $25.92
9% of jobs
$25.92 - $28.43
11% of jobs
$28.43 - $30.94
5% of jobs
$32.83 is the 75th percentile. Wages above this are outliers.
$30.94 - $33.46
6% of jobs
$33.46 - $35.97
5% of jobs
$35.97 - $38.48
5% of jobs
$38.48 - $41
3% of jobs
$41 - $43.51
10% of jobs
$15
$27
$43
How much do hcc risk adjustment coder jobs pay per hour?
What are the key skills and qualifications needed to thrive in the Hcc Risk Adjustment Coder position, and why are they important?
To thrive as an HCC Risk Adjustment Coder, you need a solid understanding of medical coding, ICD-10-CM coding guidelines, and clinical documentation, often demonstrated by a certification such as CPC, CRC, or CCS-P. Familiarity with EHR systems, risk adjustment software, and coding databases is commonly required. Attention to detail, analytical thinking, and strong communication skills set top coders apart in this field. These skills are critical for accurately capturing patient risk, ensuring compliance, and supporting optimal reimbursement for healthcare organizations.
What are some common challenges faced by HCC Risk Adjustment Coders, and how can they overcome them?
HCC Risk Adjustment Coders often encounter challenges such as incomplete or ambiguous provider documentation, frequent code updates, and tight coding accuracy standards. Staying current on industry coding guidelines, maintaining open communication with providers, and participating in regular training programs are essential strategies for overcoming these hurdles. Coders who proactively seek clarification, double-check their work, and embrace ongoing learning typically excel in this role. Addressing these challenges effectively not only improves coding quality but also supports accurate reimbursement and risk adjustment reporting.
What is an HCC Risk Adjustment Coder job?
An HCC Risk Adjustment Coder reviews medical records to identify and assign accurate Hierarchical Condition Category (HCC) codes based on documented diagnoses. These codes help determine risk adjustment scores, which impact healthcare reimbursements for Medicare Advantage and other risk-adjusted plans. Coders ensure compliance with CMS guidelines, improve documentation accuracy, and support proper reimbursement for patient care. Strong knowledge of ICD-10-CM coding, medical terminology, and risk adjustment models is essential for this role.

Full-time
Dental, Vision, Life
Posted 19 days ago
Kootenai Health rating
7.7
Based on 63 frontline employees who took The Breakroom Quiz
213th of 1,023 rated hospitals
Job description
Risk Adjustment Coding and Documentation Specialist
Position Summary
This position is responsible for facilitating the improvement in the overall quality, completeness, and accuracy of practice-based clinical diagnosis coding and documentation.
Responsibilities
• Verifies and ensures the accuracy, completeness, specificity, and appropriateness of risk adjustable diagnosis codes and clinical documentation based on services rendered
• Engages KCN clinicians and their staff by supporting and educating on pre-visit planning to include identifying severity of patient illness
• Improves the provider coding experience by ensuring KCN clinicians and their staff receive regular feedback regarding coded cases and opportunities for improved documentation
• Supports KCN practices by analyzing chart documentation related to clinical status of patient, current treatment plan, past medical history and identifies potential gaps in provider documentation
• Serves as a resource by independently educating KCN clinicians and their staff by identifying errors and issues related to diagnosis coding and documentation to bring about a positive network value program outcome
• Develops program improvement plans and training materials
• Suggests and educates appropriate solutions in accordance with nationally recognized coding guidelines
• Actively engages and collaborates with payer partners on coding recapture and resolution of diagnosis
• Utilizes software and population health application to collect, track, and communicate information related to diagnosis coding
• Collaborates with KCN Contracting, Analytics and Information System teams to discern appropriate interventions for identified performance opportunities through enhancements or optimization to data, reports and population health application
• Performs other related duties as assigned
• Familiar with standard concepts, practices, and procedures within the field
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Competent to meet age specific needs of the unit assigned
Requirements and Minimum Qualifications
• Graduate of a formal coding program or completion of a coding training course required
• Associate degree preferred
• Minimum 3 years' coding/medical record chart review experience in a healthcare setting required
• Previous Risk Adjustment Methodology and diagnosis coding experience required
• Coding certifications through AHIMA or AAPC; Outpatient Coding: Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician, (CCS-P), or other related certification required
• Certification as Risk Adjustment Coder preferred
• Experience with Hierarchical Coding Category (HCC) Risk Adjustment Model preferred
• HCC diagnosis coding and clinical record(s) review process preferred
• Strong knowledge of CPT and ICD-10 coding and medical record documentation
• Proven history of project management and/or coordinating detailed projects or activities
• Strong written and verbal communication skills, including ability to establish and build strong relationships
Working Conditions
- This position is on-site in Coeur d'Alene Idaho; Hybrid schedule available for Idaho residents
• Must be able to lift and move up to 10lbs
• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements
About Kootenai Health:
Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.
As your next employer, we are excited to offer you:
- Comprehensive medical coverage, including fully employera'paid options for eligible fulla'time employees, plus affordable plans for parta'time staff. Benefits begin on the 1st of the month following 30 days of employment.
- Dental, vision, life, and pet insurance, with telemedicine and wellbeing resources available to all employees
- Tuition assistance after 90 days to support your professional growth
- Retirement plans with prea'tax and Roth options and employer matching from 3%–6%
- Competitive pay, plus night, weekend, and PRN shift differentials
- Awarda'winning wellness program with coaching, financial wellness resources, and free or discounted access to fitness centers and premium wellbeing apps
- PerkSpot discounts providing access to thousands of exclusive deals in over 25 categories
- And an employee referral bonus program
Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you!
Apply today!
Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.
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What Kootenai Health employees say
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Benefits
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Workplace
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About Kootenai Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Coeur d'Alene", 'country_admin_code': 'US.ID, ID, US
Year founded
1956