... 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 ...
... 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 ...
... 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 ...
... 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 ...
Sr Risk Adjustment Coder
Newark, NJ · On-site
$44.13 - $57.36/hr
The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare ...
Sr Risk Adjustment Coder
Newark, NJ · On-site
$44.13 - $57.36/hr
The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
Quality Risk Adjustment Advisor IV (Health Plan experience required)
Dayton, OH · On-site +1
$83K - $132K/yr
Knowledge of HCC Risk Adjustment models * Knowledge of CMS regulatory guidelines * Strong analytical and problem-solving skills * Ability to apply AI technologies in healthcare * Strong communication ...
Quality Risk Adjustment Advisor IV (Health Plan experience required)
Dayton, OH · On-site +1
$83K - $132K/yr
Knowledge of HCC Risk Adjustment models * Knowledge of CMS regulatory guidelines * Strong analytical and problem-solving skills * Ability to apply AI technologies in healthcare * Strong communication ...
Sr. Director, Risk Adjustment (0778)
Washington, DC · On-site
$146K - $183K/yr
Deep expertise in CMS-HCC, HHS-HCC, and CDPS risk adjustment models. * Advanced proficiency in Python and/or R for statistical modeling, machine learning, and large-scale data analysis. * Strong ...
Sr. Director, Risk Adjustment (0778)
Washington, DC · On-site
$146K - $183K/yr
Deep expertise in CMS-HCC, HHS-HCC, and CDPS risk adjustment models. * Advanced proficiency in Python and/or R for statistical modeling, machine learning, and large-scale data analysis. * Strong ...
Telehealth Nurse Practitioner
Saint Louis, MO · Remote
$600 - $720/day
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Telehealth Nurse Practitioner
Saint Louis, MO · Remote
$600 - $720/day
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review ...
VP, Risk Adjustment
Long Beach, CA · On-site +1
$137K - $184K/yr
... HCC) methodology, Medicaid risk adjustment guidelines, and ACA Marketplace risk adjustment ... requirements as applicable. * Owns and governs the end-to-end data flow from coding vendor output ...
VP, Risk Adjustment
Long Beach, CA · On-site +1
$137K - $184K/yr
... HCC) methodology, Medicaid risk adjustment guidelines, and ACA Marketplace risk adjustment ... requirements as applicable. * Owns and governs the end-to-end data flow from coding vendor output ...
Telehealth Nurse Practitioner (Remote)
Saint Louis, MO · Remote
$600 - $720/hr
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Quick apply
Telehealth Nurse Practitioner (Remote)
Saint Louis, MO · Remote
$600 - $720/hr
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Telehealth Nurse Practitioner
Des Moines, IA · Remote
$600 - $720/day
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Telehealth Nurse Practitioner
Des Moines, IA · Remote
$600 - $720/day
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Manager Risk Adjustment Program
Tampa, FL · On-site +1
... HCC (Hierarchical Condition Category) and ICD-10 coding practices. * As a subject matter expert and ... Certified Risk Adjustment Coder (CRC); Certified Coding Specialist (CCS); or Registered Health ...
Manager Risk Adjustment Program
Tampa, FL · On-site +1
... HCC (Hierarchical Condition Category) and ICD-10 coding practices. * As a subject matter expert and ... Certified Risk Adjustment Coder (CRC); Certified Coding Specialist (CCS); or Registered Health ...
JOB SUMMARY The Risk Adjustment Quality Specialist plays a vital role in coordinating and ... This position requires a comprehensive understanding of Hierarchical Condition Categories (HCC ...
JOB SUMMARY The Risk Adjustment Quality Specialist plays a vital role in coordinating and ... This position requires a comprehensive understanding of Hierarchical Condition Categories (HCC ...
Telehealth Nurse Practitioner (Remote)
Charleston, WV · Remote
$600 - $720/hr
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Quick apply
Telehealth Nurse Practitioner (Remote)
Charleston, WV · Remote
$600 - $720/hr
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Risk Adjustment Quality Specialist
Lawrence, KS · On-site +1
JOB SUMMARY The Risk Adjustment Quality Specialist plays a vital role in coordinating and ... This position requires a comprehensive understanding of Hierarchical Condition Categories (HCC ...
New
Risk Adjustment Quality Specialist
Lawrence, KS · On-site +1
JOB SUMMARY The Risk Adjustment Quality Specialist plays a vital role in coordinating and ... This position requires a comprehensive understanding of Hierarchical Condition Categories (HCC ...
New
Family Medicine PA-C opening in Victorville, CA-232475
Victorville, CA · On-site
$100K - $140K/yr
Identify and accurately document chronic conditions for HCC risk adjustment * Perform thorough medication reconciliation and patient education * Collaborate with primary care providers and care ...
Family Medicine PA-C opening in Victorville, CA-232475
Victorville, CA · On-site
$100K - $140K/yr
Identify and accurately document chronic conditions for HCC risk adjustment * Perform thorough medication reconciliation and patient education * Collaborate with primary care providers and care ...
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 necessary), they will conduct medical chart reviews to identify suspect conditions, and they will design and ...
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 necessary), they will conduct medical chart reviews to identify suspect conditions, and they will design and ...
Risk Adjustment Coding Specialist II - Houston
Houston, TX · On-site +1
$70K - $85K/yr
Risk Adjustment Coding Specialist II - Houston Department: Quality - Risk Adjustment Employment ... Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs ...
Risk Adjustment Coding Specialist II - Houston
Houston, TX · On-site +1
$70K - $85K/yr
Risk Adjustment Coding Specialist II - Houston Department: Quality - Risk Adjustment Employment ... Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs ...
Telehealth Nurse Practitioner
Charleston, WV · Remote
$600 - $720/day
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Telehealth Nurse Practitioner
Charleston, WV · Remote
$600 - $720/day
Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...
Risk Adjustment Coding Specialist II - Houston
Houston, TX · Hybrid
$70K - $85K/yr
In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to ... Additionally, you'll track and report on key performance metrics--such as HCC recapture rates, AWVs ...
Quick apply
Risk Adjustment Coding Specialist II - Houston
Houston, TX · Hybrid
$70K - $85K/yr
In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to ... Additionally, you'll track and report on key performance metrics--such as HCC recapture rates, AWVs ...
HCC Risk Adjustment information
See salary details
$11K - $27.3K
0% of jobs
$27.3K - $43.5K
0% of jobs
$43.5K - $59.8K
0% of jobs
$59.8K - $76.1K
0% of jobs
$76.1K - $92.4K
0% of jobs
$92.4K - $108.6K
0% of jobs
$108.6K - $124.9K
0% of jobs
$129.3K is the 25th percentile. Wages below this are outliers.
$124.9K - $141.2K
92% of jobs
$141.2K - $157.5K
0% of jobs
$157.5K - $173.7K
0% of jobs
$173.7K - $190K
8% of jobs
$11K
$142.3K
$190K
How much do hcc risk adjustment jobs pay per year?
What are the key skills and qualifications needed to thrive in the Hcc Risk Adjustment position, and why are they important?
To excel in HCC Risk Adjustment, you need a solid understanding of medical coding, clinical documentation, healthcare regulations, and disease management, usually coupled with experience in coding certifications like CPC or CRC. Familiarity with Hierarchical Condition Category (HCC) models, data analytics tools, and electronic health record (EHR) systems is essential. Attention to detail, analytical thinking, and strong communication skills make a candidate stand out in this role. These skills ensure accurate risk adjustment coding and documentation, which are vital for appropriate reimbursement and compliance in the healthcare industry.
What are the main responsibilities of someone working in HCC Risk Adjustment?
Professionals in HCC Risk Adjustment are typically responsible for reviewing medical records, ensuring accurate coding of diagnoses aligned with CMS guidelines, and collaborating with providers to improve documentation. The role often involves analyzing patient data to identify risk gaps and providing education to clinical staff on best practices for compliant coding. Team members regularly coordinate with data analysts, providers, and compliance teams to support accurate reporting and optimal reimbursement. Overall, attention to detail and clear communication are key to meeting the organization's compliance and financial objectives.
What is an HCC Risk Adjustment job?
An HCC Risk Adjustment job involves reviewing medical records to ensure accurate coding of diagnoses under the Hierarchical Condition Category (HCC) model. This role helps determine risk scores for patients, which impact healthcare provider reimbursements in Medicare Advantage and other risk-adjusted programs. Professionals in this field, such as medical coders or auditors, analyze documentation to assign appropriate ICD-10-CM codes that reflect a patient's health status. Strong attention to detail and knowledge of coding guidelines are essential for success in this role.

Full-time
Dental, Vision, Life
Posted 21 hours ago
Kootenai Health rating
7.6
Based on 62 frontline employees who took The Breakroom Quiz
123rd of 1,004 rated hospitals
Job description
Job Code: 28980
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
- 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 employer'paid options for eligible full'time employees, plus affordable plans for part'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 pre'tax and Roth options and employer matching from 3%-6%
- Competitive pay, plus night, weekend, and PRN shift differentials
- Award'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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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