... 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 ...
Consulting Actuary - ACA Risk Adjustment
$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
$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 ...
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 ...
Coder Non-Certified
Kansas City, MO · On-site
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. What are the requirements for the job? * High school graduate or GED equivalent * Minimum 2 years' of experience in ...
Coder Non-Certified
Kansas City, MO · On-site
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. What are the requirements for the job? * High school graduate or GED equivalent * Minimum 2 years' of experience in ...
Coder Non-Certified
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. What are the requirements for the job? * High school graduate or GED equivalent * Minimum 2 years' of experience in ...
Coder Non-Certified
$21 - $28/hr
Knowledge of risk adjustment processes and coding is a plus, but not required. What are the requirements for the job? * High school graduate or GED equivalent * Minimum 2 years' of experience in ...
Senior Healthcare Data Analyst: ACA + EDGE
$83K - $105K/yr
This role will serve as a key liaison between business stakeholders, risk adjustment operations ... Support and manage complex applications systems on many platforms and manage code migrations and ...
Senior Healthcare Data Analyst: ACA + EDGE
$83K - $105K/yr
This role will serve as a key liaison between business stakeholders, risk adjustment operations ... Support and manage complex applications systems on many platforms and manage code migrations and ...
$24.25 - $27.50/hr
... including HCC's (e.g., CMS, OIG, MAC guidelines). Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations.
$24.25 - $27.50/hr
... including HCC's (e.g., CMS, OIG, MAC guidelines). Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations.
$24.25 - $27.50/hr
... standards including HCC's (e.g., CMS, OIG, MAC guidelines). • Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and ...
$24.25 - $27.50/hr
... standards including HCC's (e.g., CMS, OIG, MAC guidelines). • Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and ...
$24.25 - $27.50/hr
... HCC's (e.g., CMS, OIG, MAC guidelines). · Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations. · Collaborate ...
Quick apply
$24.25 - $27.50/hr
... HCC's (e.g., CMS, OIG, MAC guidelines). · Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations. · Collaborate ...
Senior Consultant - Clinical Documentation Specialist
Kansas City, MO · On-site
$34 - $45.50/hr
Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment * Other ... risk adjustment * Has strong interpersonal skills to collaborate with clinicians, physicians, NP ...
Senior Consultant - Clinical Documentation Specialist
Kansas City, MO · On-site
$34 - $45.50/hr
Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment * Other ... risk adjustment * Has strong interpersonal skills to collaborate with clinicians, physicians, NP ...
Manager, Contact Center - Risk Operations
Anderson, MO · On-site
$60K - $110K/yr
Provide direction on necessary operational adjustments to mitigate risk effectively. * Team ... You have a thorough understanding of Walmart's code of conduct and policies, and the ability to ...
Manager, Contact Center - Risk Operations
Anderson, MO · On-site
$60K - $110K/yr
Provide direction on necessary operational adjustments to mitigate risk effectively. * Team ... You have a thorough understanding of Walmart's code of conduct and policies, and the ability to ...
Manager, Contact Center - Risk Operations
Noel, MO · On-site
$60K - $110K/yr
Provide direction on necessary operational adjustments to mitigate risk effectively. * Team ... You have a thorough understanding of Walmart's code of conduct and policies, and the ability to ...
Manager, Contact Center - Risk Operations
Noel, MO · On-site
$60K - $110K/yr
Provide direction on necessary operational adjustments to mitigate risk effectively. * Team ... You have a thorough understanding of Walmart's code of conduct and policies, and the ability to ...
Manager, Contact Center - Risk Operations
Cassville, MO · On-site
$60K - $110K/yr
Provide direction on necessary operational adjustments to mitigate risk effectively. * Team ... You have a thorough understanding of Walmart's code of conduct and policies, and the ability to ...
Manager, Contact Center - Risk Operations
Cassville, MO · On-site
$60K - $110K/yr
Provide direction on necessary operational adjustments to mitigate risk effectively. * Team ... You have a thorough understanding of Walmart's code of conduct and policies, and the ability to ...
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner - Family Practice/Primary Care job available in Independence, Missouri
Independence, MO · On-site
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner - Family Practice/Primary Care job available in Independence, Missouri
Independence, MO · On-site
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
Independence, MO · On-site
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Nurse Practitioner, Advanced Practice Provider
Independence, MO · On-site
$126K - $148K/yr
Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs). * Passion for teamwork and the ...
Hcc Risk Adjustment Coding information
See Missouri salary details
$12.17 - $14.68
0% of jobs
$14.68 - $17.19
17% of jobs
$18.41 is the 25th percentile. Wages below this are outliers.
$17.19 - $19.70
17% of jobs
The median wage is $21.87 / hr.
$19.70 - $22.21
19% of jobs
$22.21 - $24.72
9% of jobs
$24.72 - $27.23
7% of jobs
$28.88 is the 75th percentile. Wages above this are outliers.
$27.23 - $29.74
8% of jobs
$29.74 - $32.25
6% of jobs
$32.25 - $34.76
4% of jobs
$34.76 - $37.27
6% of jobs
$37.27 - $39.78
5% of jobs
$12
$24
$39
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.
Is HCC coding a good career?
How much does a risk adjustment coder make?
How much do HCC coders make in the US?
What is an HCC risk adjustment coder?
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.

Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 27 days ago
Aledade rating
8.5
Based on 5 frontline employees who took The Breakroom Quiz
45th of 428 rated business services
Job description
- The Clinical Risk Educator performs qualitative retrospective chart reviews for prioritized practices to ensure complete and accurate clinical documentation, utilizing quantitative measures to track the frequency and types of documentation errors and gaps. By analyzing review outcomes, they pinpoint specific areas for improvement in coding and clinical documentation while identifying trends and patterns that may indicate systemic issues or training needs. This role involves synthesizing concise, high-level summaries to illustrate findings, highlighting critical areas of concern, and prioritizing recommendations for improvement. Additionally, the Educator conducts educational sessions for Aledade ACO member practices and their key staff-delivered either in person or virtually-covering review findings, clinical documentation, and risk adjustment concepts.
- Serve as an individual contributor on the Risk Education team, collaborating with team members to develop and update educational materials related to clinical documentation for both internal and external audiences, inclusive of reference guides, slide decks, and toolkits. Conduct ongoing annual reviews of repository content to ensure alignment with CMS regulatory updates.
- Research, investigate and remain up to date on both clinical and coding guidelines as they relate to clinician documentation improvement.
- Serve as a resource for appropriate clinical documentation and coding practices for assigned region.
- Bachelor's degree in a healthcare related field or equivalent work experience required
- 5+ years of clinical experience (in particular nursing or international medical backgrounds)
- Current medical coding certification such as Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), Certified Risk Adjustment Coder (CRC), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Expert Outpatient (CDEO), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), etc. through AAPC, ACDIS, or AHIMA
- 2+ years of clinical documentation improvement experience
- Extensive knowledge of ICD-10-CM, HCPCS and CPT 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 program, methodology, and impact to value-based contracts
- Comfortable presenting to large and small groups in person and in virtual format (Google Meet, Zoom, etc.)
- Ability to work both independently and collaboratively
- Flexible and able to multi-task and prioritize work load on a daily basis
- Availability for market-specific events, including the execution of 1-2 Saturday events per year in select markets
- Flexibility to work occasional evening hours, with the potential for 1-2 evenings per month on a national scale
- Active nursing credential as Registered Nurse (RN), Licensed Practical Nurse (LPN), or international medical graduate (IMG)
- Background in working directly with providers in an outpatient setting
- Experience developing and delivering clinical education and training via Google Slides or Powerpoint presentations
- Ability to use insights from clinical and quality data to address opportunities for improvement
- Advanced knowledge of Medicare billing and coding regulations, along with a deep understanding of CMS compliance standards and guidelines
- General understanding of the billing requirements and reimbursement structures for FQHCs/RHCs
- Willingness to travel as needed to Aledade's headquarters or markets
- Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
- Willingness to travel as needed to Aledade's headquarters or markets (est. up to 25% across the year).
About Aledade
Sourced by ZipRecruiter
Aledade is a leader in population health that is using innovative, value based solutions to transform the way physicians interact with their patients. We are on a mission to change healthcare for the better and solve complex problems within the healthcare system. We follow the simple but radical idea that Aledade only succeeds when our partner practices succeed. From our cutting-edge technology platform to practice transformation services, we provide physicians with everything they need to create and run an accountable care organization (ACO), revamping the way they practice and getting them back to where they should be: quarterbacking their patients' health care! Our customized solutions help clinicians in communities across America preserve their autonomy, deliver better care to their patients, reduce overall costs, and keep independent physician practices flourishing.
Industry
Health care and social assistance
Company size
501 - 1,000 Employees
Headquarters location
Bethesda, MD, US
Year founded
2014