Expertise in CMS Risk Adjustment Data Validation (RADV) for Medicare Advantage Plans, and medical coding, including but not limited to E/M, ICD-10, CPT, and HCC coding preferred. Able to keyboard 40 ...
Expertise in CMS Risk Adjustment Data Validation (RADV) for Medicare Advantage Plans, and medical coding, including but not limited to E/M, ICD-10, CPT, and HCC coding preferred. Able to keyboard 40 ...
SR. HCC Coder
West Hills, CA · On-site
$30 - $33/hr
Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation ...
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SR. HCC Coder
West Hills, CA · On-site
$30 - $33/hr
Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation ...
Certified Risk Adjustment Coder (CRC), Senior Associate
Los Angeles, CA · Hybrid
$85K - $200K/yr
Certified in Risk Adjustment Coding (CRC) with at least five (5) recent years of experience in HCC/Risk Adjustment and/or RADV Audit Methodology * Associate's or Bachelor's degree preferred, but not ...
Certified Risk Adjustment Coder (CRC), Senior Associate
Los Angeles, CA · Hybrid
$85K - $200K/yr
Certified in Risk Adjustment Coding (CRC) with at least five (5) recent years of experience in HCC/Risk Adjustment and/or RADV Audit Methodology * Associate's or Bachelor's degree preferred, but not ...
The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider ... Maintain records of training. 9. Suggests new Physician Group Risk Adjustment coding initiatives.
The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider ... Maintain records of training. 9. Suggests new Physician Group Risk Adjustment coding initiatives.
National Coding Educator - Remote
Irvine, CA · Remote
$29.25 - $33.25/hr
Supports providers in understanding CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation and diagnosis coding to ensure compliance
National Coding Educator - Remote
Irvine, CA · Remote
$29.25 - $33.25/hr
Supports providers in understanding CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation and diagnosis coding to ensure compliance
The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider ... Maintain records of training. 9. Suggests new Physician Group Risk Adjustment coding initiatives.
The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider ... Maintain records of training. 9. Suggests new Physician Group Risk Adjustment coding initiatives.
National Coding Educator - Remote
Irvine, CA · On-site +1
$29.25 - $33.25/hr
Supports providers in understanding CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation and diagnosis coding to ensure compliance
National Coding Educator - Remote
Irvine, CA · On-site +1
$29.25 - $33.25/hr
Supports providers in understanding CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation and diagnosis coding to ensure compliance
Strong knowledge of Medicare Advantage, HCC coding, and risk adjustment * Proficient in EMR documentation and medical coding best practices * Excellent communication and patient engagement skills ...
Strong knowledge of Medicare Advantage, HCC coding, and risk adjustment * Proficient in EMR documentation and medical coding best practices * Excellent communication and patient engagement skills ...
Family Medicine Nurse Practitioner opening in Victorville, CA-232476
Victorville, CA · On-site
$100K - $140K/yr
Strong knowledge of Medicare Advantage, HCC coding, and risk adjustment * Proficient in EMR documentation and medical coding best practices * Excellent communication and patient engagement skills ...
Family Medicine Nurse Practitioner opening in Victorville, CA-232476
Victorville, CA · On-site
$100K - $140K/yr
Strong knowledge of Medicare Advantage, HCC coding, and risk adjustment * Proficient in EMR documentation and medical coding best practices * Excellent communication and patient engagement skills ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Long Beach, CA · Remote
$24.50 - $33.50/hr
Certified Coding Specialist - Physician Based (CCS-P). Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. Background in supporting risk adjustment management activities and ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Long Beach, CA · Remote
$24.50 - $33.50/hr
Certified Coding Specialist - Physician Based (CCS-P). Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. Background in supporting risk adjustment management activities and ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Long Beach, CA · On-site +1
$19.84 - $38.69/hr
... Coding Specialist - Physician Based (CCS-P). • Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. • Background in supporting risk adjustment management activities and ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Long Beach, CA · On-site +1
$19.84 - $38.69/hr
... Coding Specialist - Physician Based (CCS-P). • Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. • Background in supporting risk adjustment management activities and ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Long Beach, CA · Remote
$19.84 - $38.69/hr
Certified Coding Specialist - Physician Based (CCS-P). Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. Background in supporting risk adjustment management activities and ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Long Beach, CA · Remote
$19.84 - $38.69/hr
Certified Coding Specialist - Physician Based (CCS-P). Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. Background in supporting risk adjustment management activities and ...
Manager, Clinical Operations - Risk Adjustment & Quality
La Crescenta, CA · On-site
$100K - $140K/yr
Key Responsibilities Risk Adjustment & Coding Support * Support the implementation and ongoing management of risk adjustment programs across business lines to promote accurate and compliant coding ...
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Manager, Clinical Operations - Risk Adjustment & Quality
La Crescenta, CA · On-site
$100K - $140K/yr
Key Responsibilities Risk Adjustment & Coding Support * Support the implementation and ongoing management of risk adjustment programs across business lines to promote accurate and compliant coding ...
Strong knowledge of Medicare Advantage, HCC coding, and risk adjustment * Proficient in EMR documentation and medical coding best practices * Excellent communication and patient engagement skills ...
Strong knowledge of Medicare Advantage, HCC coding, and risk adjustment * Proficient in EMR documentation and medical coding best practices * Excellent communication and patient engagement skills ...
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
$285K - $332K/yr
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
$285K - $332K/yr
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
Requires an in-depth understanding of risk adjustment models (CMS-HCC, HHS-HCC), Official Coding Guidelines, payer policies, and regulatory requirements (CMS, HHS, OIG, DHCS) * Requires exceptional ...
Requires an in-depth understanding of risk adjustment models (CMS-HCC, HHS-HCC), Official Coding Guidelines, payer policies, and regulatory requirements (CMS, HHS, OIG, DHCS) * Requires exceptional ...
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
Hcc Risk Adjustment Coding information
See California salary details
$13.96 - $16.84
0% of jobs
$16.84 - $19.72
17% of jobs
$21.12 is the 25th percentile. Wages below this are outliers.
$19.72 - $22.60
17% of jobs
The median wage is $25.08 / hr.
$22.60 - $25.48
19% of jobs
$25.48 - $28.36
9% of jobs
$28.36 - $31.24
7% of jobs
$33.13 is the 75th percentile. Wages above this are outliers.
$31.24 - $34.12
8% of jobs
$34.12 - $37
6% of jobs
$37 - $39.87
4% of jobs
$39.87 - $42.75
6% of jobs
$42.75 - $45.63
5% of jobs
$13
$28
$45
How much do hcc risk adjustment coding jobs pay per hour?
What are the key skills and qualifications needed to thrive in the Hcc Risk Adjustment Coding position, and why are they important?
To thrive as an HCC Risk Adjustment Coder, you need a strong understanding of medical coding guidelines, ICD-10-CM codes, and risk adjustment principles, typically supported by a certification such as CPC, CRC, or CCS-P. Familiarity with electronic health record systems and risk adjustment software is essential for accurate coding and data analysis. Attention to detail, critical thinking, and effective communication skills are important soft skills for ensuring documentation integrity and collaborating with healthcare providers. These competencies are crucial to accurately capture patient complexity, optimize reimbursement, and support compliance in healthcare organizations.
What are the typical challenges faced by HCC Risk Adjustment Coders, and how can they overcome them?
HCC Risk Adjustment Coders often face challenges such as interpreting complex medical records, staying up-to-date with evolving coding guidelines, and ensuring thorough documentation to support accurate risk scoring. To overcome these challenges, coders should engage in continuous education, collaborate closely with healthcare providers for clarification, and utilize available coding resources and team support. Staying organized and maintaining a detail-oriented approach will also help ensure that codes are assigned correctly and all relevant conditions are captured. Working as part of a supportive team can further ease the process, providing opportunities for knowledge sharing and professional development.
What is an HCC Risk Adjustment Coding job?
An HCC Risk Adjustment Coding job involves reviewing medical records to assign Hierarchical Condition Category (HCC) codes based on documented diagnoses. Coders ensure accurate risk adjustment by following ICD-10-CM coding guidelines, which impact reimbursement for healthcare providers and insurance plans. This role requires knowledge of medical terminology, compliance regulations, and risk adjustment models used in Medicare Advantage and other programs.

Loma Linda University Health rating
8.1
Based on 86 frontline employees who took The Breakroom Quiz
108th of 995 rated hospitals
Job description
Please Note: This is a hybrid position; however, applicants must reside in California and live within a 2-hour radius of Redlands, CA to be considered.
Department: UHC: Managed Care
Job Summary: The Coder 1 Risk Adjustment is responsible for concurrent, prospective, and retrospective clinical documentation review as it pertains to Risk Adjustment Data Validation (RADV) timelines, with an emphasis on completeness and accuracy of provider documentation related to severity of illness and supporting clinical care plan(s) for the validation of Hierarchical Condition Category (HCC) diagnoses. Initiates communication, verbal and written, with providers to facilitate clarification of need for greater specificity, clinical support, and/or completeness of the progress notes. Provides compliant education related to documentation integrity, completeness, and consistency. Keeps providers up to date on CMS, ICD-10-CM, AHA Coding, health plan etc. guidelines as it pertains to Risk Adjustment for the purpose of, documentation trends and opportunities for improvement related to documentation integrity. Performs other duties as needed.
Education and Experience: Bachelor's degree in Health Information Management or other clinical/healthcare degree preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements.2+ years overall combined clinical/medical experience with at least 1+ year of Risk Adjustment coding specific experience or Clinical Documentation Improvement/Specialist equivalent.
Knowledge and Skills: Comprehensive understanding of the contents of a typical electronic medical record, medical terminology, abbreviations, ICD-10-CM coding conventions. Expertise in CMS Risk Adjustment Data Validation (RADV) for Medicare Advantage Plans, and medical coding, including but not limited to E/M, ICD-10, CPT, and HCC coding preferred. Able to keyboard 40 wpm. Able to read; write legibly; speak in English with professional quality; use computer, printer and software programs necessary to the position; operate/troubleshoot basic office equipment require for the position. Able to relate and communicate positively, effectively, and professionally with others; be assertive and consistent in following or enforcing policies; work calmly and respond courteously when under pressure; collaborate; and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; work independently with minimal supervision; performs basic math functions; manage multiple assignments effectively; work well under pressure; problem solve; organize and prioritize workload; recall information with accuracy; pay close attention to detail. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, medical records, and written documents necessary to position.
Licensures and Certifications: Certified Risk Adjustment Coder (CRC) required; Certified Clinical Documentation Specialist (CCDS) preferred. An equivalent combination of Risk Adjustment Coding work experience and other relevant American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification may be substituted for the stated certification requirements.
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About Loma Linda University Health
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Loma Linda University Health (LLUH) is an esteemed healthcare organization situated in Loma Linda, California, US. Established in 1905, it was initially known as the College of Medical Evangelists, and it operated as the official medical institution of the Seventh-day Adventist Church until the name was changed to LLUH in 1961. LLUH is very much active in the healthcare and education sectors, providing a vast range of services such as medical treatment, research, and health education. The organization’s core mission is "to continue the teaching and healing ministry of Jesus Christ", which underlines its binding values of compassion, integrity, excellence, freedom, and justice.
Industry
Health care and social assistance and hospitality services
Company size
10,000+ Employees
Headquarters location
Loma Linda, CA, US