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Hcc Risk Adjustment Coder Jobs in Chicago, IL (NOW HIRING)

Bcbsa

Head of Medicare Performance Hub

Chicago, IL · On-site

CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...

Bcbsa

Medicare Plan Management Principal

Chicago, IL · Hybrid

Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...

Strive Health

Nurse Practitioner

Chicago, IL · 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 ...

Strive Health

Nurse Practitioner

Merrillville, IN · 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 ...

Strive Health

Nurse Practitioner

Merrillville, IN · 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 ...

Strive Health

Nurse Practitioner

Schererville, IN · 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 ...

Strive Health

Nurse Practitioner

Chicago, IL · 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 ...

Strive Health

Nurse Practitioner

Schererville, IN · 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 ...

Strive Health

Nurse Practitioner

Chicago, IL · On-site

$120K - $151K/yr

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 ...

Strive Health

Nurse Practitioner

Merrillville, IN · On-site

$112K - $140K/yr

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 ...

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Hcc Risk Adjustment Coder information

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$28

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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 Chicago, IL is $28.34, according to ZipRecruiter salary data. Most workers in this role earn between $19.57 and $35.67 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.
What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Chicago, IL? The most popular types of Hcc Risk Adjustment Coder jobs in Chicago, IL are:
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What job categories do people searching Hcc Risk Adjustment Coder jobs in Chicago, IL look for? The top searched job categories for Hcc Risk Adjustment Coder jobs in Chicago, IL are:
Hcc Risk Adjustment Coder jobs near you
Infographic showing various Hcc Risk Adjustment Coder job openings in Chicago, IL as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 9% Part Time, and 3% Contract. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution, with an average salary of $58,952 per year, or $28.3 per hour.

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Northbrook, IL

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,332 frontline employees who took The Breakroom Quiz

89th of 112 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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