The HCC/RAF Coding Nurse is responsible for conducting comprehensive medical record reviews and assigning accurate ICD-10-CM diagnosis codes for risk adjustment-eligible patients. This role supports ...
The HCC/RAF Coding Nurse is responsible for conducting comprehensive medical record reviews and assigning accurate ICD-10-CM diagnosis codes for risk adjustment-eligible patients. This role supports ...
The HCC/RAF Coding Nurse is responsible for conducting comprehensive medical record reviews and assigning accurate ICD-10-CM diagnosis codes for risk adjustment-eligible patients. This role supports ...
The HCC/RAF Coding Nurse is responsible for conducting comprehensive medical record reviews and assigning accurate ICD-10-CM diagnosis codes for risk adjustment-eligible patients. This role supports ...
Quality Specialist LPN
Greenfield, MA · On-site
$26.21 - $37.33/hr
HCC coding and risk adjustment review and analysis: review patients for targeted diagnosis gaps and update the EMR to reflect appropriate HCC diagnosis, and perform chart prep for the upcoming ...
Quick apply
Quality Specialist LPN
Greenfield, MA · On-site
$26.21 - $37.33/hr
HCC coding and risk adjustment review and analysis: review patients for targeted diagnosis gaps and update the EMR to reflect appropriate HCC diagnosis, and perform chart prep for the upcoming ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
Medical Billing Coder
Wellesley, MA · Remote
$20.50 - $27.50/hr
Utilize comprehensive knowledge American Hospital Association (AHA) coding principles of CPT, HCPCS, ICD9-CM/ICD10-CM diagnosis and procedure codes to evaluate medical record documentation for HCC ...
Medical Billing Coder
Wellesley, MA · Remote
$20.50 - $27.50/hr
Utilize comprehensive knowledge American Hospital Association (AHA) coding principles of CPT, HCPCS, ICD9-CM/ICD10-CM diagnosis and procedure codes to evaluate medical record documentation for HCC ...
Medical Coder II
Lynn, MA · On-site
$18.22 - $24.52/hr
HCC or DxCG coding experience. * Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. * Experienced communicating ...
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Medical Coder II
Lynn, MA · On-site
$18.22 - $24.52/hr
HCC or DxCG coding experience. * Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. * Experienced communicating ...
... coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management). * Evaluate current vendor ...
... coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management). * Evaluate current vendor ...
Manager, Risk Adjustment
Worcester, MA · On-site
... coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management). * Evaluate current vendor ...
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Manager, Risk Adjustment
Worcester, MA · On-site
... coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management). * Evaluate current vendor ...
Manager, Risk Adjustment
Worcester, MA · On-site
$90K/yr
... coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management). * Evaluate current vendor ...
Manager, Risk Adjustment
Worcester, MA · On-site
$90K/yr
... coding validation) programs, ensuring complete, accurate, and compliant HCC documentation under the applicable CMS-HCC model (including V24 -V28 transition management). * Evaluate current vendor ...
Research Analyst
Holyoke, MA · On-site
$69K - $76K/yr
HCC serves over 9,000 students annually, and provides a variety of recreational and cultural ... Develops, maintains, and updates syntax/codes, reports, and data extracts to fulfill recurring and ...
Research Analyst
Holyoke, MA · On-site
$69K - $76K/yr
HCC serves over 9,000 students annually, and provides a variety of recreational and cultural ... Develops, maintains, and updates syntax/codes, reports, and data extracts to fulfill recurring and ...
Research Analyst
$69K - $76K/yr
HCC serves over 9,000 students annually, and provides a variety of recreational and cultural ... Develops, maintains, and updates syntax/codes, reports, and data extracts to fulfill recurring and ...
Research Analyst
$69K - $76K/yr
HCC serves over 9,000 students annually, and provides a variety of recreational and cultural ... Develops, maintains, and updates syntax/codes, reports, and data extracts to fulfill recurring and ...
Research Assistant I - Radiation Oncology
Boston, MA · On-site
$21 - $28.75/hr
... the DF/HCC Clinical Trials Office and/or MGB Institutional Review Board (IRB). The Research ... Experience with version control systems (Git / GitHub) for collaborative, reproducible code
Research Assistant I - Radiation Oncology
Boston, MA · On-site
$21 - $28.75/hr
... the DF/HCC Clinical Trials Office and/or MGB Institutional Review Board (IRB). The Research ... Experience with version control systems (Git / GitHub) for collaborative, reproducible code
Research Scientist (Harvard TH Chan School of Public Health)
Boston, MA · On-site
$145K - $162K/yr
Independently represents the department on HCC and DFCI committees, including but not limited to ... Expert at statistical methodology, and the use of statistical software, coding, data analysis and ...
Research Scientist (Harvard TH Chan School of Public Health)
Boston, MA · On-site
$145K - $162K/yr
Independently represents the department on HCC and DFCI committees, including but not limited to ... Expert at statistical methodology, and the use of statistical software, coding, data analysis and ...
Research Assistant I - Radiation Oncology
Boston, MA · On-site
$21 - $28.75/hr
... the DF/HCC Clinical Trials Office and/or MGB Institutional Review Board (IRB). The Research ... Experience with version control systems (Git / GitHub) for collaborative, reproducible code
Research Assistant I - Radiation Oncology
Boston, MA · On-site
$21 - $28.75/hr
... the DF/HCC Clinical Trials Office and/or MGB Institutional Review Board (IRB). The Research ... Experience with version control systems (Git / GitHub) for collaborative, reproducible code
Hcc Coding information
See Massachusetts salary details
$20.01 is the 25th percentile. Wages below this are outliers.
$17.33 - $20.07
26% of jobs
$20.07 - $22.82
9% of jobs
$22.82 - $25.56
12% of jobs
The median wage is $26.93 / hr.
$25.56 - $28.31
9% of jobs
$28.31 - $31.05
11% of jobs
$31.05 - $33.79
5% of jobs
$35.85 is the 75th percentile. Wages above this are outliers.
$33.79 - $36.54
6% of jobs
$36.54 - $39.28
5% of jobs
$39.28 - $42.03
5% of jobs
$42.03 - $44.77
3% of jobs
$44.77 - $47.52
10% of jobs
$17
$30
$47
How much do hcc coding jobs pay per hour?
As of Jul 26, 2026, the average hourly pay for hcc coding in Massachusetts is $30.02, according to ZipRecruiter salary data. Most workers in this role earn between $20.72 and $37.79 per hour, depending on experience, location, and employer.
Is HCC coding a good career?
HCC coding involves assigning Hierarchical Condition Category codes for healthcare reimbursement and risk adjustment, requiring knowledge of medical terminology and coding systems like ICD-10. It offers opportunities for remote work, steady demand, and potential certification through programs like AHIMA or AAPC. The career can be stable and rewarding for those interested in healthcare administration and medical coding.
What is the highest paid coding job?
HCC coding, which involves medical coding for healthcare facilities, typically offers salaries that vary based on experience, certifications, and location. Senior coding specialists with advanced certifications like CCS or CPC-H tend to earn higher salaries, especially in specialized or management roles within healthcare organizations.
What are some common challenges faced by HCC Coders, and how can they be addressed in a healthcare setting?
HCC Coders often encounter challenges such as incomplete or ambiguous medical documentation, frequent updates to coding guidelines, and the need for ongoing collaboration with providers to ensure accurate capture of risk adjustment data. These challenges can be addressed by maintaining open communication with clinicians, participating in regular training on coding updates, and utilizing auditing tools to review and improve documentation quality. Proactively seeking clarification and staying current with industry standards are key to success in this role.
What are the key skills and qualifications needed to thrive as an HCC Coder, and why are they important?
To thrive as an HCC Coder, you need a solid understanding of medical coding, risk adjustment models, and clinical documentation, typically with a certification such as CPC, CCS, or CRC. Familiarity with coding software, EHR systems, and the CMS HCC risk adjustment model is essential. Attention to detail, analytical thinking, and effective communication skills distinguish top performers in this field. These skills ensure accurate coding for risk adjustment, which directly impacts healthcare reimbursement and compliance.
What is HCC coding?
HCC coding stands for Hierarchical Condition Category coding, which is a risk adjustment model used primarily by Medicare to estimate future healthcare costs for patients. HCC coders review medical records to identify and assign the appropriate ICD-10 codes that capture a patient's diagnoses and health conditions. Accurate HCC coding ensures proper reimbursement for healthcare providers and helps reflect the complexity of a patient’s health status. This process is essential for risk adjustment in value-based care models.
What is the difference between Hcc Coding vs Medical Coding?
| Aspect | Hcc Coding | Medical Coding |
|---|---|---|
| Required Credentials | Certification (e.g., CPC, CCS), specialized training in HCC | Certification (e.g., CPC, CCS), general medical coding training |
| Work Environment | Healthcare facilities, insurance companies, risk adjustment teams | Hospitals, clinics, physician offices, insurance companies |
| Industry Usage | Risk adjustment, Medicare Advantage, Medicaid | Billing, reimbursement, medical record management |
| Search & Comparison Intent | Hcc Coding vs Medical Coding | Medical Coding |
Hcc Coding focuses on risk adjustment and insurance reimbursement, requiring specialized knowledge of Hierarchical Condition Categories. Medical Coding covers a broader range of medical billing and record-keeping tasks. While both roles involve coding, Hcc Coding is more specialized for insurance and risk management, whereas Medical Coding is essential for general healthcare billing and documentation.
What is a hcc in coding?
In HCC coding, HCC stands for Hierarchical Condition Categories, which are used in risk adjustment models to predict healthcare costs based on patient diagnoses. HCC coding involves assigning specific codes to medical conditions to accurately reflect patient health status for insurance reimbursement and data analysis. Accurate HCC coding requires knowledge of ICD-10 codes and often involves specialized training or certification.
How much do HCC medical coders make in the US?
HCC medical coders in the US typically earn between $50,000 and $70,000 annually, depending on experience, certification, and location. Skilled coders with certifications like CPC or CCS and experience in risk adjustment coding tend to earn higher salaries.
What are popular job titles related to Hcc Coding jobs in Massachusetts? For Hcc Coding jobs in Massachusetts, the most frequently searched job titles are:
What job categories do people searching Hcc Coding jobs in Massachusetts look for? The top searched job categories for Hcc Coding jobs in Massachusetts are:
What cities in Massachusetts are hiring for Hcc Coding jobs? Cities in Massachusetts with the most Hcc Coding job openings:
Full-time
Medical, Dental, Vision, Life, Retirement
Posted 11 days ago
Baystate Health rating
6.4
Based on 141 frontline employees who took The Breakroom Quiz
643rd of 890 rated healthcare providers
Job description
Registered Nurse - HCC/RAF Coding Specialist
SUMMARY:
The HCC/RAF Coding Nurse is responsible for conducting comprehensive medical record reviews and assigning accurate ICD-10-CM diagnosis codes for risk adjustment-eligible patients. This role supports the organization's Population Health and Value-Based Care initiatives by ensuring complete, accurate, and compliant documentation of chronic conditions in accordance with Centers for Medicare & Medicaid Services (CMS) and Hierarchical Condition Category (HCC) guidelines.
Working collaboratively with providers and clinical staff, the HCC/RAF Coding Nurse identifies documentation opportunities, promotes coding accuracy, improves the completeness of patient problem lists, and supports appropriate reimbursement through Medicare Risk Adjustment (RAF) and quality initiatives, including Healthcare Effectiveness Data and Information Set (HEDIS). This position also serves as a clinical coding resource by providing education and guidance to providers while improving documentation quality, patient outcomes, and provider satisfaction.
This position complies with all organizational policies, regulatory requirements, and applicable federal and state laws while performing other duties as assigned.
RESPONSIBILITIES:
SCHEDULE:
QUALIFICATIONS:
THE ADVANTAGES OF WORKING WITH BAYSTATE!
We strive to be the place where you can build the career you deserve-apply today! You belong at Baystate!
All correspondence can be directed to:
Kimberly Jeznach
Healthcare Recruiter
kimberly.jeznach@baystatehealth.org
Education:
Associates Degree (Required)
Certifications:
Driver License - OtherOtherOther, Registered Nurse - State of MassachusettsState of MassachusettsState of Massachusetts
Compensation
Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.
Minimum - Midpoint - Maximum
$89,606.00 - $103,001.00 - $121,804.00
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
SUMMARY:
The HCC/RAF Coding Nurse is responsible for conducting comprehensive medical record reviews and assigning accurate ICD-10-CM diagnosis codes for risk adjustment-eligible patients. This role supports the organization's Population Health and Value-Based Care initiatives by ensuring complete, accurate, and compliant documentation of chronic conditions in accordance with Centers for Medicare & Medicaid Services (CMS) and Hierarchical Condition Category (HCC) guidelines.
Working collaboratively with providers and clinical staff, the HCC/RAF Coding Nurse identifies documentation opportunities, promotes coding accuracy, improves the completeness of patient problem lists, and supports appropriate reimbursement through Medicare Risk Adjustment (RAF) and quality initiatives, including Healthcare Effectiveness Data and Information Set (HEDIS). This position also serves as a clinical coding resource by providing education and guidance to providers while improving documentation quality, patient outcomes, and provider satisfaction.
This position complies with all organizational policies, regulatory requirements, and applicable federal and state laws while performing other duties as assigned.
RESPONSIBILITIES:
- Review medical records and assign accurate ICD-10-CM diagnosis codes in accordance with CMS HCC guidelines.
- Identify documentation gaps and collaborate with providers to clarify incomplete, conflicting, or ambiguous documentation.
- Maintain accurate patient problem lists by adding, updating, and resolving diagnoses as appropriate.
- Identify and validate chronic conditions that impact Medicare Risk Adjustment (RAF) and quality reporting.
- Educate providers and staff on HCC coding, documentation improvement, and coding best practices.
- Utilize risk adjustment reports to prioritize chart reviews, provider education, and documentation improvement efforts.
- Promote Medicare Annual Wellness Visits to support preventive care, documentation accuracy, and risk adjustment capture.
- Support clinical outcome initiatives, quality improvement projects, Population Health initiatives, and patient onboarding activities.
- Maintain compliance with organizational policies, CMS regulations, ICD-10-CM coding standards, and applicable federal and state laws.
- Perform other duties as assigned.
SCHEDULE:
- Full-Time, 40-hours per week
- Monday-Friday, no holidays or weekends
- Hybrid work schedule with the ability to travel to practices throughout the Baystate Health System to conduct provider education, trainings, and on-site documentation improvement initiatives.
QUALIFICATIONS:
- Associate Degree in Nursing (ADN) required; Bachelor of Science in Nursing (BSN) preferred.
- Current Massachusetts Registered Nurse (RN) license required.
- Minimum of three (3) years of clinical RN experience required.
- Valid driver's license required.
- Physician practice clinical experience may be considered.
- Experience with HCC/RAF coding, Medicare Risk Adjustment, Clinical Documentation Improvement (CDI), or Population Health preferred.
- Experience with electronic medical record systems; Cerner experience preferred.
- Strong clinical knowledge of chronic disease management.
- Knowledge of ICD-10-CM coding, CMS HCC guidelines, Medicare Risk Adjustment methodologies, HEDIS, and Clinical Documentation Improvement (CDI) principles.
- Exceptional analytical and critical thinking skills with the ability to interpret complex clinical documentation and coding requirements.
- Strong presentation, facilitation, and provider education skills with the ability to effectively communicate complex coding and regulatory concepts to diverse clinical audiences.
- Demonstrated ability to build collaborative relationships with providers and clinical staff through education, coaching, and consultation.
- Excellent communication, organizational, analytical, and problem-solving skills.
- Proficiency with Microsoft Office applications and electronic medical record systems.
- Ability to work independently while managing multiple priorities and maintaining high productivity, accuracy, and quality standards.
- Self-motivated with a commitment to continuous learning and maintaining current knowledge of CMS HCC, ICD-10-CM, Medicare Risk Adjustment, and related regulatory guidelines.
THE ADVANTAGES OF WORKING WITH BAYSTATE!
- Excellent compensation
- High-quality, low-cost medical, dental, and vision insurance
- Pet, home, auto, and personal insurance
- Certification and continuing education reimbursement
- 403(b) retirement plan with company match and annual company contribution increases based on years of service
- Life insurance
- Free financial coaching from a certified professional
- Reimbursement for well-being activities, including gym memberships, fitness equipment, personal training, massage, and more
- Well-being programs supporting mental, physical, and financial health
We strive to be the place where you can build the career you deserve-apply today! You belong at Baystate!
All correspondence can be directed to:
Kimberly Jeznach
Healthcare Recruiter
kimberly.jeznach@baystatehealth.org
Education:
Associates Degree (Required)
Certifications:
Driver License - OtherOtherOther, Registered Nurse - State of MassachusettsState of MassachusettsState of Massachusetts
Compensation
Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.
Minimum - Midpoint - Maximum
$89,606.00 - $103,001.00 - $121,804.00
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
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