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Hcc Risk Adjustment Medical Coder Jobs (NOW HIRING)

Vertek Staffing

HCC Risk Adjustment Coder

Franklin, TN · Remote

$18 - $24/hr

Review medical records to identify and code HCC-eligible diagnoses. * Assign ICD-10-CM diagnosis codes in accordance with CMS and Risk Adjustment guidelines. * Validate chronic conditions and ensure ...

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Review medical records to ensure complete and accurate capture of HCC-eligible conditions supported ... CRC (Certified Risk Coder) , CCS , CPC , or RHIA credential. * Experience with risk adjustment ...

Bcbsri

Risk Adjustment Medical Coder

Providence, RI · On-site +1

$65K - $98K/yr

... risk adjustment payments.Perform data validation of collected medical codes from both outpatient ... Knowledge of Hierarchical Condition Category (HCC) payment model and American Hospital Association ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · Remote

$22.50 - $31/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · On-site +1

$22.50 - $31/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk ...

Altegra Health

Remote Certified Coders

Memphis, TN · Remote

$21.75 - $29.75/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. ...

Altegra Health

Remote Certified Coders

Memphis, TN · On-site +1

$21.75 - $29.75/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Qualifications: • Active nursing license (RN or LPN) and/or certified coder certification through ...

Centrum Health

Risk Adjustment Analyst

Doral, FL

Using SQL code, mine data on medical spend, clinical data and population health data and derive ... Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP ...

GeBBS Healthcare Solutions

Risk Adjustment Coder (C)

Job Type Full-time Description This is a flexible CMS HCC/Risk Validation Audit role for a seasonal ... Minimum 5 years verifiable risk adjustment coding experience post certification * Must be able to ...

Pedim

HCC Coder

Lecanto, FL · On-site

$13.75 - $18.50/hr

This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ... You will be responsible for reviewing medical records, identifying appropriate HCC diagnoses ...

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Hcc Risk Adjustment Medical Coder information

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

As of Jul 17, 2026, the average hourly pay for hcc risk adjustment medical coder in the United States is $22.42, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $24.04 per hour, depending on experience, location, and employer.

What are HCC Risk Adjustment Medical Coders?

HCC Risk Adjustment Medical Coders are professionals who review and analyze medical records to assign appropriate ICD-10 codes for diagnoses and procedures. Their primary goal is to ensure accurate documentation for Hierarchical Condition Category (HCC) risk adjustment, which affects healthcare reimbursement and quality reporting for Medicare Advantage and other risk-based programs. These coders play a critical role in helping healthcare organizations receive appropriate payments and in supporting high-quality patient care by ensuring that all relevant health conditions are properly documented.

What is the difference between Hcc Risk Adjustment Medical Coder vs Medical Coder?

AspectHcc Risk Adjustment Medical CoderMedical Coder
CertificationsCertified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC)Certified Professional Coder (CPC), Certified Coding Associate (CCA)
Work EnvironmentHealthcare facilities, insurance companies, risk adjustment teamsHospitals, clinics, physician offices
Industry UsageHealth plans, Medicare Advantage, MedicaidHospitals, outpatient clinics, physician practices

The main difference between an Hcc Risk Adjustment Medical Coder and a Medical Coder lies in their focus. Hcc Risk Adjustment Medical Coders specialize in risk adjustment coding for health plans, requiring knowledge of HCC models and risk scores. Medical Coders generally focus on clinical coding for billing and documentation across various healthcare settings. While both roles require coding certifications, Hcc Risk Adjustment Medical Coders have additional expertise in risk models and insurance industry standards.

What are some common challenges faced by HCC Risk Adjustment Medical Coders, and how can they be addressed?

HCC Risk Adjustment Medical Coders often encounter challenges such as interpreting complex patient records, keeping up with frequent updates to coding guidelines, and ensuring accurate capture of diagnoses for risk adjustment. To address these, coders benefit from strong attention to detail, regular training on ICD-10 and CMS risk adjustment updates, and effective communication with providers to clarify clinical documentation. Many coders also collaborate with auditing teams to resolve discrepancies and ensure compliance with regulatory standards, which helps maintain coding accuracy and data integrity.

What are the key skills and qualifications needed to thrive as an HCC Risk Adjustment Medical Coder, and why are they important?

To thrive as an HCC Risk Adjustment Medical Coder, you need a thorough understanding of ICD-10-CM coding, risk adjustment models, and healthcare regulations, typically supported by a coding certification such as CPC, CRC, or CCS. Proficiency with electronic health record (EHR) systems, coding software, and data analytics tools is essential for accurate documentation and reporting. Attention to detail, analytical thinking, and strong communication skills help coders interpret clinical documentation and collaborate with providers. These skills ensure accurate risk adjustment coding, which directly impacts healthcare reimbursement and compliance.
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Hcc Risk Adjustment Medical Coder jobs near you
Infographic showing various Hcc Risk Adjustment Medical Coder job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $46,638 per year, or $22.4 per hour.
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • Remote

$42.79 - $48.75/hr

Other

Posted yesterday

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor
  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required. 
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position. 

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