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Hcc Risk Adjustment Coder Jobs in Philadelphia, PA

Jj

Dir, HCC -Joints, Dig./Comm Ex

West Chester, PA · On-site

Familiarity with industry codes such asAdvaMed. Other * Language: English (required). * Travel: Up ... Audit and Compliance Trends, Audit Management, Compliance Management, Compliance Risk, Consulting ...

Ennoble Care

Actuary

Philadelphia, PA · Remote

$150/hr

Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models * Experience working with CMS and CMMI total cost of care (ACO) programs * Proven track record ...

Ennoble Care

Actuary

Marlton, NJ · Remote

$150/hr

Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models * Experience working with CMS and CMMI total cost of care (ACO) programs * Proven track record ...

Axia Women's Health

Director, Coding

Voorhees, NJ · On-site

Its rapidly growing network spans OB/GYN care, breast health, high-risk pregnancy care ... Reviews KPIs daily and take an active role in making appropriate adjustments to ensure goals are ...

Axia Women's Health

Director, Coding

Voorhees, NJ · On-site

Its rapidly growing network spans OB/GYN care, breast health, high-risk pregnancy care ... Reviews KPIs daily and take an active role in making appropriate adjustments to ensure goals are ...

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All JobsHcc Risk Adjustment Coder JobsHcc Risk Adjustment Coder Jobs in Philadelphia, PA

Hcc Risk Adjustment Coder information

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

As of Aug 15, 2026, the average hourly pay for hcc risk adjustment coder in Philadelphia, PA is $27.74, according to ZipRecruiter salary data. Most workers in this role earn between $19.18 and $34.95 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 Philadelphia, PA?

The most popular types of Hcc Risk Adjustment Coder jobs in Philadelphia, PA are:

What are popular job titles related to Hcc Risk Adjustment Coder jobs in Philadelphia, PA?

For Hcc Risk Adjustment Coder jobs in Philadelphia, PA, the most frequently searched job titles are:

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The top searched job categories for Hcc Risk Adjustment Coder jobs in Philadelphia, PA are:

Hcc Risk Adjustment Coder jobs near you
Infographic showing various Hcc Risk Adjustment Coder job openings in Philadelphia, PA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, 1% Temporary, and 4% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $57,702 per year, or $27.7 per hour.

Manager, Revenue Cycle Management

Daymark Health

Philadelphia, PA • On-site

$120K - $135K/yr

Full-time

Re-posted 16 days ago

Job description

Daymark Health is a value-based oncology company redefining the cancer care experience for patients, providers, and health plans. Daymark's comprehensive, personalized cancer care platform empowers patients with dedicated care navigation, symptom-focused support, behavioral health care, and social resources. Combined with evidence-based health interventions and a hybrid in-person + virtual care model, Daymark is improving the overall cancer experience for patients, providers, and health plans – and setting a new standard in cancer care.

Daymark's groundbreaking approach is led by CEO Dr. Justin Bekelman, a pioneer in transforming cancer care, alongside some of the nation's foremost leaders in oncology and value-based care. Daymark Health is backed by Maverick Ventures, Yosemite, Oncology Ventures, Healthier Capital, Blue Venture Fund, and Healthcare Foundry.

Be cautious of recruitment fraud, and always confirm that communications are coming from an official Daymark Health email.

ABOUT THE ROLE

We are seeking a highly capable operator to build and lead Revenue Cycle Management at Daymark. You will own the end-to-end revenue cycle function, including professional billing, third-party billing vendor management, claims operations, and risk adjustment, while partnering closely with Clinical Operations, Finance, Product, and Data.

The right candidate brings deep technical fluency in billing and claims processing end to end, hands-on experience managing billing vendors and clearinghouse platforms, and a forward-thinking orientation toward AI-enabled RCM. This role is ideal for someone who wants to build a function from the ground up and grow with it.

WHAT YOU'LL DO

Own Daymark's Revenue Cycle Operations

  • Lead end-to-end RCM across all payer types, with primary focus on Original Medicare and value-based contract populations
  • Establish patient billing workflows including statement generation, cost-sharing communication, and collections processes; ensure workflows are sensitive to the patient experience while maintaining collection integrity
  • Manage the third-party billing vendor relationship, including performance monitoring, issue escalation, contract compliance, and ongoing optimization
  • Own the claims and clearinghouse platform, including submission workflows, rejection and denial management, and resubmission processes
  • Establish and track RCM KPIs: clean claim rate, denial rate, days in AR, net collection rate, and others
  • Partner with Finance on revenue recognition, cash flow forecasting, and month-end close support

Risk Adjustment

  • Support accurate risk adjustment operations aligned with our care model and payer contracts
  • Partner with Clinical Operations, Product and Data to ensure risk adjustment workflows are reflected in tooling and supported from pre-chart prep to documentation and through billing and claim submission

Credentialing

  • Support end-to-end enrollment workflows for new providers, including NPI registration, CAQH profile maintenance, and payer-specific credentialing applications
  • Track credentialing status and expiration timelines across the provider panel to ensure no gaps in billing eligibility
  • Partner with Clinical Operations and People to build onboarding workflows that sequence credentialing milestones with provider start dates
  • Identify and manage credentialing vendors or delegated credentialing arrangements where applicable

AI and Technology in RCM

  • Identify and evaluate AI-enabled tools across the RCM workflow, including automated coding assistance, denial prediction, and other capabilities
  • Partner with Product and Data to pilot and implement capabilities that improve throughput and accuracy

Operational Infrastructure

  • Translate billing and compliance requirements into scalable operational workflows
  • Establish audit and QA processes to ensure coding accuracy and billing integrity
  • Identify execution gaps and drive resolution across cross-functional teams

WHAT WE ARE LOOKING FOR

Experience

  • Direct experience managing a third-party billing vendor and a claims/clearinghouse platform
  • Experience with HCC coding, risk adjustment suspecting, and chart review workflows
  • Familiarity with AI applications in RCM and a genuine interest in applying them
  • Experience at a startup or high-growth healthcare company is a plus

Qualities

  • You are both strategic and highly execution-oriented; you can design the system and work within it
  • You bring strong analytical instincts and are comfortable working with billing data directly
  • You can partner effectively across clinical, operational, finance, and technical teams
  • You are energized by building from scratch
  • You have high standards for compliance and billing integrity

ADDITIONAL INFORMATION

This role is fully remote, but will be expected to work on either Eastern or Central time zone hours. We are unable to sponsor work visas for this role.

Compensation: $120,000 - $135,000 annually, depending on location & experience.