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Hcc Risk Adjustment Coding Jobs in Phoenix, AZ (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · 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 ...

Aledade

Clinical Risk Educator, Remote

Phoenix, AZ · Remote

... 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 ...

Aledade

Clinical Risk Educator, Remote

Phoenix, AZ

... 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 ...

Icon Consultants

Medical Coder II

Phoenix, AZ · Remote

$21.50/hr

This role requires strong expertise in medical coding standards, risk adjustment practices, and regulatory compliance. The specialist will collaborate with internal teams and providers to ensure ...

Arizona Priority Care

Nurse Practioner

Chandler, AZ

... Risk Adjustment Factor (RAF) and Hierarchical Condition Categories (HCC) model measures and how ... diagnosis codes. * Educates and guides patients on disease prevention and health promotion ...

Arizona Priority Care

Nurse Practioner

Chandler, AZ

... Risk Adjustment Factor (RAF) and Hierarchical Condition Categories (HCC) model measures and how ... diagnosis codes. * Educates and guides patients on disease prevention and health promotion ...

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Hcc Risk Adjustment Coding information

See Phoenix, AZ salary details

$13

$27

$43

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

As of Jun 12, 2026, the average hourly pay for hcc risk adjustment coding in Phoenix, AZ is $27.11, according to ZipRecruiter salary data. Most workers in this role earn between $20.43 and $33.27 per hour, depending on experience, location, and employer.

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?

HCC risk adjustment coding is a growing field within healthcare that involves assigning diagnosis codes to predict patient risk and determine reimbursement. It requires knowledge of medical terminology, coding systems, and often certification, offering opportunities for stable employment and career advancement. Many professionals find it a rewarding career due to its demand and specialized skill set.

How much does a risk adjustment coder make?

In Texas, risk adjustment coders typically earn between $50,000 and $70,000 annually, depending on experience, certifications, and employer. Advanced skills in medical coding and familiarity with risk adjustment software can lead to higher salaries.

How much do HCC 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 and strong knowledge of risk adjustment principles can earn higher salaries, especially in larger healthcare markets.

What is an HCC risk adjustment coder?

An HCC risk adjustment coder is a professional who reviews medical records and assigns Hierarchical Condition Category (HCC) codes to accurately reflect a patient's health conditions. This coding supports risk adjustment models used by insurance companies to determine reimbursement and plan payments, requiring knowledge of medical coding systems like ICD-10 and familiarity with healthcare documentation. Accuracy and attention to detail are essential in this role, which often involves working with electronic health records and coding software.

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.

What are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Phoenix, AZ? The most popular types of Hcc Risk Adjustment Coding jobs in Phoenix, AZ are:
What are popular job titles related to Hcc Risk Adjustment Coding jobs in Phoenix, AZ? For Hcc Risk Adjustment Coding jobs in Phoenix, AZ, the most frequently searched job titles are:
What job categories do people searching Hcc Risk Adjustment Coding jobs in Phoenix, AZ look for? The top searched job categories for Hcc Risk Adjustment Coding jobs in Phoenix, AZ are:
Hcc Risk Adjustment Coding jobs near you
Infographic showing various Hcc Risk Adjustment Coding job openings in Phoenix, AZ as of June 2026, with employment types broken down into 70% Full Time, 10% Part Time, and 20% Contract. Highlights an 78% Physical, 4% Hybrid, and 18% Remote job distribution, with an average salary of $56,392 per year, or $27.1 per hour.
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Tempe, AZ • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

227th of 261 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

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 identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • Certified professional coder (CPC)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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