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Hcc Risk Adjustment Jobs (NOW HIRING)

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 ...

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 ...

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 ...

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 ...

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 ...

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HCC Risk Adjustment information

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$11K

$142.3K

$190K

How much do hcc risk adjustment jobs pay per year?

As of Jul 5, 2026, the average yearly pay for hcc risk adjustment in the United States is $142,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $132,500.00 and $132,500.00 per year, depending on experience, location, and employer.

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.

More about HCC Risk Adjustment jobs
What cities are hiring for Hcc Risk Adjustment jobs? Cities with the most Hcc Risk Adjustment job openings:
What are the most commonly searched types of Hcc Risk Adjustment jobs? The most popular types of Hcc Risk Adjustment jobs are:
What states have the most Hcc Risk Adjustment jobs? States with the most job openings for Hcc Risk Adjustment jobs include:
Infographic showing various Hcc Risk Adjustment job openings in the United States as of June 2026, with employment types broken down into 98% Full Time, 1% Part Time, and 1% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $142,322 per year, or $68.4 per hour.
Risk Adjustment Coding and Documentation Specialist

Risk Adjustment Coding and Documentation Specialist

Kootenai Health

Coeur D Alene, ID • On-site

Full-time

Dental, Vision, Life

Posted 21 hours ago


Kootenai Health rating

7.6

Company rating: 7.6 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

123rd of 1,004 rated hospitals


Job description

Risk Adjustment Coding and Documentation Specialist
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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