... HCC Mode; or any combination of education and experience, which would provide an equivalent ... Prefer AAPC Certified Risk Adjustment Coder (CRC) certification. Job Level: Manager Workshift: 1st ...
... HCC Mode; or any combination of education and experience, which would provide an equivalent ... Prefer AAPC Certified Risk Adjustment Coder (CRC) certification. Job Level: Manager Workshift: 1st ...
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 ...
Consulting Actuary - ACA Risk Adjustment
Kansas City, MO · On-site
$143K - $229K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Consulting Actuary - ACA Risk Adjustment
Kansas City, MO · On-site
$143K - $229K/yr
Deep experience with ACA Risk Adjustment , including HHS-HCC model methodology, risk score ... Strong understanding of diagnosis coding (ICD-10-CM) , provider documentation practices, and their ...
Drive performance related to value-based care programs, HCC documentation, risk adjustment, and care gap closure. * Promote evidence-based medicine and High Reliability Organization (HRO) principles ...
Drive performance related to value-based care programs, HCC documentation, risk adjustment, and care gap closure. * Promote evidence-based medicine and High Reliability Organization (HRO) principles ...
Drive performance related to value-based care programs, HCC documentation, risk adjustment, and care gap closure. * Promote evidence-based medicine and High Reliability Organization (HRO) principles ...
Drive performance related to value-based care programs, HCC documentation, risk adjustment, and care gap closure. * Promote evidence-based medicine and High Reliability Organization (HRO) principles ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews (Accreditation) 4. And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders ...
CMS HCC Risk Adjustment * HEDIS * Medical Record Reviews (Accreditation) * And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders, and RHIT or RHIA professionals to ...
CMS HCC Risk Adjustment * HEDIS * Medical Record Reviews (Accreditation) * And more About the Job: We are currently recruiting RNs, LPNs, MA's, Certified Coders, and RHIT or RHIA professionals to ...
Coder - Certified (CPC)
Kansas City, MO · On-site
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. Qualifications: * High school graduate or GED equivalent * Must possess a current AAPC certification * Minimum 1 years ...
Coder - Certified (CPC)
Kansas City, MO · On-site
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. Qualifications: * High school graduate or GED equivalent * Must possess a current AAPC certification * Minimum 1 years ...
Coder - Certified (CPC)
Kansas City, MO · On-site
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. Qualifications: * High school graduate or GED equivalent * Must possess a current AAPC certification * Minimum 1 years ...
Coder - Certified (CPC)
Kansas City, MO · On-site
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. Qualifications: * High school graduate or GED equivalent * Must possess a current AAPC certification * Minimum 1 years ...
Risk Adjustment Analytics * Validation Activities * Reporting Workflows * Build reusable code libraries and shared assets. * Support enterprise reporting and healthcare operations. Snowflake ...
Risk Adjustment Analytics * Validation Activities * Reporting Workflows * Build reusable code libraries and shared assets. * Support enterprise reporting and healthcare operations. Snowflake ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Senior Business Technical Analyst
$87K - $157K/yr
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment ...
Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers ... Liaise with office and laboratory staff to provide reimbursement support and test coding.
Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers ... Liaise with office and laboratory staff to provide reimbursement support and test coding.
Identify opportunities to impact risk adjustment factors through documentation of complicating and ... Facilitate communication and collaboration among coders, providers, and nurses to identify ...
Quick apply
Identify opportunities to impact risk adjustment factors through documentation of complicating and ... Facilitate communication and collaboration among coders, providers, and nurses to identify ...
Nurse Practitioner
Saint Louis, MO · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Saint Louis, MO · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Kansas City, MO · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Kansas City, MO · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Hcc Risk Adjustment Coder information
See Missouri salary details
$17.19 is the 25th percentile. Wages below this are outliers.
$14.88 - $17.24
26% of jobs
$17.24 - $19.60
9% of jobs
$19.60 - $21.95
12% of jobs
The median wage is $23.13 / hr.
$21.95 - $24.31
9% of jobs
$24.31 - $26.67
11% of jobs
$26.67 - $29.03
5% of jobs
$30.79 is the 75th percentile. Wages above this are outliers.
$29.03 - $31.38
6% of jobs
$31.38 - $33.74
5% of jobs
$33.74 - $36.10
5% of jobs
$36.10 - $38.45
3% of jobs
$38.45 - $40.81
10% of jobs
$14
$25
$40
How much do hcc risk adjustment coder jobs pay per hour?
What is an HCC Risk Adjustment Coder?
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 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 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 the most commonly searched types of Hcc Risk Adjustment Coder jobs in Missouri?
The most popular types of Hcc Risk Adjustment Coder jobs in Missouri are:
What are popular job titles related to Hcc Risk Adjustment Coder jobs in Missouri?
For Hcc Risk Adjustment Coder jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Hcc Risk Adjustment Coder jobs in Missouri look for?
The top searched job categories for Hcc Risk Adjustment Coder jobs in Missouri are:

Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA)
Saint Louis, MO • On-site
Other
Posted 28 days ago
Elevance Health rating
7.6
Based on 353 frontline employees who took The Breakroom Quiz
215th of 315 rated insurance
Job description
Manager Clinical Performance & Quality Coding
LOCATION: The position requires that you be in the office 3x per week. You must be within a commutable distance of one of our eligible offices.
HOURS: General business hours, Monday through Friday (8-5 central)
Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Responsible for leading the quality documentation and value capture for all provider visit medical encounters to ensure application of accurate diagnosis codes (ICD-10 codes).
Primary duties include but not limited to:
- Serves as the primary resource and subject matter expert on all CMS Risk Adjustment and quality documentation.
- Develop and deliver clinical focused training on advance coding and documentation while incorporating coder feedback.
- Liaison to the clinical leadership on alignment of goals and workflows to support value capture initiatives and high-quality clinical documentation.
- Develop performance management plan, KPI's and clinical level tracking to meet quarterly goals for coding timeliness, accuracy, and Risk Adjustment.
- Develop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures.
- Develop operational and clinical workflows for closing HEDIS care opportunities to ensure practices and health plan success.
- Participate in peer review of medical documentation for completed visits notes as well as patient profile information in EMR.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Required Qualifications
- Current, active, valid, and unrestricted nurse practitioner (NP) or PA license in applicable state(s) required.
- Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
- Requires experience with CMS Risk Models.
Preferred Qualifications
- You must have previous management/supervisory experience with direct reports.
- HEDIS experience is preferred.
- Experience with clinical data/documentation integrity is preferred (CDEO or CDEI).
- Prefer AAPC Certified Risk Adjustment Coder (CRC) certification.
Job Level: Manager
Workshift: 1st Shift (United States of America)
Job Family: MED > Licensed Nurse
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About Elevance Health
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Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Indianapolis, IN, US
Year founded
2004