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Hcc Risk Adjustment Coding Jobs in Raleigh, NC (NOW HIRING)

Duke Health

COMPLIANCE SPECIALIST-Remote

Durham, NC · Remote

... billing risk areas, report results to PB Operations for action plan Analyzes coded records for ... HCC coding/auditing * Multi-Specialty Coding/Auditing * Examples: * Interventional Radiology

Keebler Health

Solutions Engineer

Durham, NC · On-site

As a member of the team, you won't just write code or stay in your lane-you'll shape critical ... Exposure to risk adjustment , RAF scoring , or clinical data quality workflows. What Success Looks ...

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Hcc Risk Adjustment Coding information

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$13

$26

$42

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

As of Sep 9, 2026, the average hourly pay for hcc risk adjustment coding in Raleigh, NC is $26.80, according to ZipRecruiter salary data. Most workers in this role earn between $20.19 and $32.88 per hour, depending on experience, location, and employer.

What is an HCC Risk Adjustment Coding?

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 key skills and qualifications needed to thrive in HCC Risk Adjustment Coding?

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 Risk Adjustment Coding a good career?

Hcc Risk Adjustment Coding is a growing field within healthcare that involves analyzing patient data to improve risk adjustment models, often requiring knowledge of medical terminology and coding systems like ICD-10. It offers opportunities for stable employment, remote work, and career advancement, especially for those with certification and experience in medical coding. The role is in demand as healthcare organizations focus on accurate risk assessment and reimbursement.

What are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Raleigh, NC?

The most popular types of Hcc Risk Adjustment Coding jobs in Raleigh, NC are:

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For Hcc Risk Adjustment Coding jobs in Raleigh, NC, the most frequently searched job titles are:

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The top searched job categories for Hcc Risk Adjustment Coding jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Hcc Risk Adjustment Coding jobs?

Cities near Raleigh, NC with the most Hcc Risk Adjustment Coding job openings:

Hcc Risk Adjustment Coding jobs near you
Infographic showing various Hcc Risk Adjustment Coding job openings in Raleigh, NC as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 81% Physical, 4% Hybrid, and 15% Remote job distribution, with an average salary of $55,753 per year, or $26.8 per hour.

COMPLIANCE SPECIALIST-Remote

Durham, NC • Remote

Duke Health
See more jobs at Duke Healthexternal

Full-time

Posted 21 days ago

Duke Health rating

7.2

Company rating: 7.2 out of 10

Based on 256 frontline employees who took The Breakroom Quiz

344th of 898 rated healthcare providers

Job description

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.


This position is 100% remote. All Duke University remote workers must reside in one of the following states:

North Carolina,Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington.

*Now offering a $10,000 sign-on bonus that will pay out in 4 equal installments over 24 months - 6-month increments.

General Description of the Job Class:

The Compliance Specialist Auditor will perform coding quality audits of inpatient records to assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and to provide ongoing feedback and identification of the education needs for the providers and staff.

Duties and Responsibilities

PRIMARY FUNCTION: Monthly QA Audits of PB coders.

Monitor data quality and optimal reimbursement to the hospital by performing retrospective quality audits for accurate coding of ICD-10-CM diagnoses or CPT-4 procedures (and appropriate use of modifiers) for professional and outpatient services using Center for Medicare and Medicaid coding guidelines, standards and regulations.

Should be able to adequately utilize coding resources to back up any findings within audit

Responsible for performing medical record reviews to ensure that documentation supports the assigned codes.

Performs focused/integrated audits; when necessary

Serves as subject matter coding expert

Collaborates with outside departments

Serves as the expert for coding questions

Identify coding and billing risk areas, report results to PB Operations for action plan

Analyzes coded records for compliance with federal, state and third party insurer rules and regulations and note trends.

Excellent verbal and written communication

Sets the tone for ethical behavior, actively models ethical behavior to set an example for others

Identifies issues and discusses them in a timely and constructive manner to obtain a rapid and effective resolution

Performs other related duties incidental to the work described herein and other related work as assigned.

HIGHLY SOUGHT AFTER SKILLS:

  • HCC coding/auditing
  • Multi-Specialty Coding/Auditing
    • Examples:
      • Interventional Radiology
      • Cardiothoracic
      • Ortho (Foot and Ankle Specifically)
      • Critical Care
      • Observation Services
      • ED
      • Edits/Denials
      • Gen Surg
      • Trauma
      • Peds
      • GI
      • Anesthesia
  • Good work ethic
  • Strong sense of responsibility
  • Ability to work independently

Required Qualifications at this Level:

Education:

  • High School Diploma, required

Experience:

  • Four (4) years of coding review experience in applying compliance, auditing and coding principles as they relate to professional coding and billing
  • Or equivalent combination of relevant education and/or experience.

Degrees, Licensure, and/or Certification:

  • Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) and/or Certified Coding Specialist (CCS), required
  • Certified Risk Coder (CRC), Certified Professional Medical Auditor (CPMA)- Added bonus credentials

Knowledge, Skills, and Abilities:

Knowledge of:

  • ICD-10-CM and CPT/HCPCS coding guidelines to effectively apply to outpatient diagnoses and procedures.
  • Knowledge of prospective payment systems and thorough understanding of DRG/APC reimbursement methodologies and coding validation.
  • Understanding of anatomy, physiology, pharmacology and medical terminology.

Ability to:

  • Achieve thoroughness and accuracy in task completion
  • Analyze detailed information to determine appropriate compliance with coding and reimbursement regulations
  • Establish and maintain effective working relationships
  • Communicate clearly and concisely
  • Identify trends within audits

Systems

  • Epic experience preferred; 3M 360 CAC, Audit Manager
  • MS Office Applications (Word, Excel, Visio, Access, PowerPoint)

Distinguishing Characteristics of this Level:

All job performance relates to the strategic goals of DUHS and its entities. All DUHS staff are expected to live Duke's Core Value: Caring for our patients, their loved ones and each other. Demonstrating commitment to excellence, safety, integrity, diversity and teamwork.


Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.


Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.


Essential Physical Job Functions:

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.


Employment Type: FULL_TIME

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