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Hcc Risk Adjustment Coder Jobs in Texas (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

St Luke's Health

Value Based Coder II

Houston, TX · On-site

$25.30 - $35.74/hr

The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk ... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ...

St Luke's Health

Value Based Coder II

Houston, TX

$25.30 - $35.74/hr

The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk ... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ...

CommonSpirit Health

Value Based Coder II

Houston, TX · On-site

$18 - $23.75/hr

The Value Based Coder II is an experienced professional within the Quality Management/Risk team ... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ...

St. Luke's Health

Value Based Coder II

Houston, TX · On-site +1

$25.30 - $35.74/hr

The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk ... as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC ...

Universal Health Services

RN Field Coder

Mcallen, TX · On-site

Minimum of two (2+) years in CMS HCC Risk Adjustment Coding. * Minimum of two (2+) years' experience in medical records, claims or billing area is an asset or equivalent combination of education and ...

CenterWell

IPA Consultative Coding Manager

Austin, TX · On-site

Certified Professional Coder (CPC) or equivalent certification (RHIA, RHIT, CRC or CCS) Preferred Qualifications: * Expertise in risk adjustment, HCC coding, and CMS guidelines * Experience in ...

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

As of Aug 12, 2026, the average hourly pay for hcc risk adjustment coder in Texas is $25.61, according to ZipRecruiter salary data. Most workers in this role earn between $17.69 and $32.26 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?

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.

Is Hcc Risk Adjustment Coder coding a good career?

Hcc Risk Adjustment Coder is a specialized healthcare role focused on accurate coding for risk adjustment purposes, often requiring knowledge of medical terminology and coding systems like ICD-10. It offers steady employment opportunities, especially in healthcare organizations and insurance companies, with potential for certification and career advancement. The role typically involves working in an office environment and may require ongoing education to stay current with coding updates.

How much do Hcc Risk Adjustment Coders make in the US?

Hcc Risk Adjustment Coders in the US typically earn between $50,000 and $80,000 annually, depending on experience, certification, and location. Experienced coders with certifications like CPC or CCS may earn higher salaries, especially in healthcare hubs or with specialized skills in coding and documentation. Salaries can also vary based on whether the role is remote or onsite and the complexity of the coding tasks involved.
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Hcc Risk Adjustment Coder jobs near you
Infographic showing various Hcc Risk Adjustment Coder job openings in Texas as of August 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $53,274 per year, or $25.6 per hour.

Risk Adjustment Coding Specialist II - Houston

Astrana Health, Inc.

Houston, TX

$70K - $85K/yr

Full-time

Re-posted 17 days ago

Job description

Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market.  In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. 
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! This position requires travel to provider offices twice a week in the Houston area.
Our Values: 
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC) 
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines 
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC certification, CPC and CRC.
  • At least 3 years of experience in risk adjustment coding and/or billing experience required.
  • At least 1 year of experience with targeted provider education.
  • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate 
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.
You're great for this role if:    
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting


Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybrid work structure where the expectation is to work in the office, in the field and at home on a weekly basis. 19500 HWY 249, Suite 570 Houston, TX 77070. The expectation is to work in office or out in the field two times per week. 
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.    

Additional Information:     
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.