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Hcc Risk Adjustment Medical Coder Jobs in Colorado

Southern Colorado Clinic PC

MEDICAL CODER

Pueblo, CO · On-site

$18 - $25/hr

MEDICAL CODER POSITION TYPE: FULL TIME REPORTS TO: BUSINESS OFFICE MANAGER FLSA CATEGORY: NON ... Post all credit and debit adjustments to patient accounts with strict adherence to the company ...

Southern Colorado Clinic PC

MEDICAL CODER

Pueblo, CO · On-site

$18 - $25/hr

MEDICAL CODER POSITION TYPE: FULL TIME REPORTS TO: BUSINESS OFFICE MANAGER FLSA CATEGORY: NON ... Post all credit and debit adjustments to patient accounts with strict adherence to the company ...

Southern Colorado Clinic

MEDICAL CODER

Pueblo, CO · On-site

$18.50 - $24.50/hr

MEDICAL CODER POSITION TYPE: FULL TIME REPORTS TO: BUSINESS OFFICE MANAGER FLSA CATEGORY: NON ... Post all credit and debit adjustments to patient accounts with strict adherence to the company ...

DaVita, Inc.

Nurse Practitioner Educator

Denver, CO · On-site +1

Experience in ICD-10 coding and documentation requirements and risk adjustment. * Knowledge of compliant query writing/process. * Ability to perform a comprehensive chart review of 20-30 medical ...

DaVita, Inc.

Nurse Practitioner Educator

Denver, CO · On-site +1

Experience in ICD-10 coding and documentation requirements and risk adjustment. * Knowledge of compliant query writing/process. * Ability to perform a comprehensive chart review of 20-30 medical ...

Stryker Corporation

Medical Director

Denver, CO · On-site

$180 - $220/hr

The HCC is a AAAHC-accredited institution, and the Medical Director serves a key role in updating ... Experience with quality improvement, risk management, accreditation or regulatory compliance, and ...

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Hcc Risk Adjustment Medical Coder information

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 Colorado as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution.
Sr. Manager, Risk Adjustment Analytics

Sr. Manager, Risk Adjustment Analytics

Staffingine LLC

Denver, CO • On-site

Full-time

Re-posted 6 days ago

Job description

Job Title: Sr Manager, Risk Adjustment Analytics 
Job Location: Denver, CO 
Job Type: Full Time 

Job Description:  

  • Provide strategic leadership and management for the IKC Risk Adjustment Accuracy 

  • Create and maintain leadership reports on IKC revenue financials and estimating impact IKC initiatives had on Medical Loss Ratio (MLR) 

  • Write SQL queries against data warehouses containing clinical operations and medical claims data to support analytic requests and deliver insights to various stakeholders 

  • Monitor evolving regulations and policies to ensure all processes and reporting meet compliance requirements 

  • Partner with clinical, financial, operational, legal, compliance, and IT teams to improve risk adjustment accuracy 

  • Serve as a subject matter expert on CMS risk adjustment for the enterprise and stay current on the latest industry trends 

  • Other duties as assigned 

Required Experience: 

  • 3 or more years’ professional experience with healthcare data, specifically medical claims and/or encounter data using SQL 

  • 3 or more years’ experience in healthcare financial management, healthcare consulting, medical economics, population health, and/or similar experience  

  • At least a year’s experience in creation, implementation, and impact estimation of prospective and retrospective risk adjustment initiatives, including CMS RAPS/Encounter data submissions 

  • Experience developing and managing direct reports 

Skills and knowledge needed to succeed in this role: 

  • Expert level knowledge of CMS-HCC models V24 and V28, claims data lifecycle, submission systems, regulation, compliance, and audits related to risk adjustment 

  • Strong understanding of healthcare economics, population health, and value based care 

  • Ability to work collaboratively in a cross functional team environment and communicate effectively with teammates at all levels in an organization 

  • Comfortable presenting complex analysis and insights to executive audience 

  • Intellectual curiosity, strategic thinking and strong project management skills 

  • Comfort with ambiguous, ever-changing situations 

  • Strong entrepreneurial mindset with the motivation to continuously improve the status quo and drive this independently 

Must-haves 

  • Experience developing and managing direct reports Expert level knowledge of CMS-HCC models V24 and V28, claims data lifecycle, submission systems, regulation, compliance, and audits related to risk adjustment Strong understanding of healthcare economics, population health, and value based care Ability to work collaboratively in a cross functional team environment and communicate effectively with teammates at all levels in an organization Comfortable presenting complex analysis and insights to executive audience Intellectual curiosity, strategic thinking and strong project management skills Comfort with ambiguous, ever-changing situations Strong entrepreneurial mindset with the motivation to continuously improve the status quo and drive this independently