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Hcc Risk Adjustment Coder Jobs in Iowa (NOW HIRING)

University of Iowa

CDI Quality Analyst

Iowa City, IA · On-site

... coders to clarify at-risk documentation to ensure accurate claim submission (American Health ... risk adjustment variables. Provides ongoing education as needed for all areas of specialty.

University of Iowa

CDI Quality Analyst

Iowa City, IA · On-site

... coders to clarify at-risk documentation to ensure accurate claim submission (American Health ... risk adjustment variables. Provides ongoing education as needed for all areas of specialty.

Loenbro

Project Manager

Cedar Rapids, IA

Conduct risk assessments and develop mitigation strategies. * Team Management: Build and lead ... Handle project changes and scope adjustments efficiently, ensuring minimal impact on project ...

Loenbro

Project Manager

Cedar Rapids, IA · On-site

Conduct risk assessments and develop mitigation strategies. * Team Management: Build and lead ... Handle project changes and scope adjustments efficiently, ensuring minimal impact on project ...

Ryan Companies

Field Site Specialist

Des Moines, IA

... risk mitigation, regulatory compliance, and mentorship. You will serve as a critical interface ... Support the Quality Team in enforcing procedures and ensure all work meets contract and code ...

Asset Living

Community Manager

Des Moines, IA

... risk management. As an on-site leader, you will supervise all aspects of the property and staff to ... Monitor the timely receipt, reconciliation, and coding of all vendor invoices * Ensure property ...

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How much do hcc risk adjustment coder jobs pay per hour?

As of Jun 22, 2026, the average hourly pay for hcc risk adjustment coder in Iowa is $25.82, according to ZipRecruiter salary data. Most workers in this role earn between $17.84 and $32.50 per hour, depending on experience, location, and employer.

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.

What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Iowa? The most popular types of Hcc Risk Adjustment Coder jobs in Iowa are:
What are popular job titles related to Hcc Risk Adjustment Coder jobs in Iowa? For Hcc Risk Adjustment Coder jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Hcc Risk Adjustment Coder jobs in Iowa look for? The top searched job categories for Hcc Risk Adjustment Coder jobs in Iowa are:
Hcc Risk Adjustment Coder jobs near you
Manager of Payment Integrity

Manager of Payment Integrity

Medical Associates

Dubuque, IA • On-site

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 20 days ago

Job description

Medical Associates Health Plans is hiring a Manager of Payment Integrityto join our team!
Where You Will Be Working:
Medical Associates Clinic and Health Plans is a multi-specialty group practice combined with a growing health insurance company. Our 1,100 healthcare and health insurance professionals lead the way in providing quality healthcare and top-notch insurance products in Northeast Iowa, Southwest Wisconsin, and Northwest Illinois. This position is an onsite positionlocated at the Medical Associates Health Plans in Dubuque, Iowa.
Benefits Package Includes:
  • Single or Family Health Insurance with discounted premium rates for wellness program participation.
  • 401k with immediate matching (50% on the dollar up to 7% of pay) + additional annual Profit Sharing
  • Flexible Paid Time Off Program (29 days off/year)
  • Medical and Dependent Care Flex Spending Accounts
  • Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.
Major Responsibilities:
  • Program Leadership and Staff Supervision
    Supervise payment integrity-related staff, including roles supporting clinical documentation, coding, and claims audit functions. Provide coaching, mentoring, performance feedback, and professional development. Oversee daily workflows related to claim audits, risk adjustment validation, large claim reviews, appeals, and recoveries. Establish priorities, assign work, monitor productivity and quality standards, and implement process improvements to enhance efficiency, accuracy, and compliance. Serve as a subject matter resource for payment integrity policies, audit methodologies, and payerspecific requirements.
  • Claims Audit and Payment Validation Activities
    Conduct detailed, linebyline medical and ancillary claim audits using associated medical records, coding guidelines, and provider contracts. Validate medical necessity when applicable, confirm correct coding and reimbursement, and identify overpayments or underpayments. Investigate discrepancies, document findings, and collaborate with internal departments and providers to support corrections, recoveries, and process improvement.
  • Large Claim, Risk Adjustment, and Reinsurance Support
    Provide targeted oversight of highdollar claims (greater than $50,000), including pre and postpayment review. Support risk adjustment accuracy through validation of diagnosis coding and documentation. Coordinate with Finance and Claims to support reinsurance identification, documentation, and submission processes.
  • Payment Integrity Program Oversight, Appeals, and Provider Collaboration
    Oversee the relationship and performance of payment integrity consultants and vendors, including management of workflows, audit tools, and program policies to ensure accuracy, effectiveness, and annual updates. Lead and support payment integrity-related appeals, including review of cases, development of rationale, and preparation of supporting documentation. Coordinate with internal stakeholders to ensure consistency in determinations and alignment with program goals. Collaborate with Provider Relations and Contracting to support provider communication, education, and issue resolution related to billing practices, documentation, and audit findings.
  • Fraud, Waste, and Abuse (FWA) Collaboration
    Identify potential FWA indicators through audit and analytical activities. Collaborate with the Special Investigations Unit (SIU) by referring suspected FWA cases and supporting investigations as requested.
  • Reporting, Compliance, and Other Duties
    Prepare summary data and reporting for leadership, including audit outcomes, financial impact, trends, and improvement opportunities. Maintain accurate audit records and ensure adherence to federal, state, and payerspecific regulations. Complete additional projects and duties as assigned.
Knowledge and Skills:
Experience Three to five years of similar or related experience
Education Equivalent to a twoyear college degree or completion of a specialized course of study or certification at a business or trade school. Valid RN license is required; medical coding experience is preferred.
Interpersonal Skills A significant level of trust and diplomacy is required, in addition to normal courtesy and tact. Work involves extensive personal contact with others and/or is usually of a personal or sensitive nature. Work may involve motivating or influencing others. Outside contacts become important and fostering sound relationships with other entities (companies and/or individuals) becomes necessary.
Employment Type: Full-Time

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