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Hcc Risk Adjustment Jobs in California (NOW HIRING)

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Hcc Risk Adjustment information

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$10.9K

$140.5K

$187.5K

How much do hcc risk adjustment jobs pay per year?

As of Aug 15, 2026, the average yearly pay for hcc risk adjustment in California is $140,459.00, according to ZipRecruiter salary data. Most workers in this role earn between $130,800.00 and $130,800.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the HCC Risk Adjustment position, and why are they important?

To excel in HCC Risk Adjustment, you need a solid understanding of medical coding, clinical documentation, healthcare regulations, and disease management, usually coupled with experience in coding certifications like CPC or CRC. Familiarity with Hierarchical Condition Category (HCC) models, data analytics tools, and electronic health record (EHR) systems is essential. Attention to detail, analytical thinking, and strong communication skills make a candidate stand out in this role. These skills ensure accurate risk adjustment coding and documentation, which are vital for appropriate reimbursement and compliance in the healthcare industry.

What are the main responsibilities of someone working in HCC Risk Adjustment?

Professionals in HCC Risk Adjustment are typically responsible for reviewing medical records, ensuring accurate coding of diagnoses aligned with CMS guidelines, and collaborating with providers to improve documentation. The role often involves analyzing patient data to identify risk gaps and providing education to clinical staff on best practices for compliant coding. Team members regularly coordinate with data analysts, providers, and compliance teams to support accurate reporting and optimal reimbursement. Overall, attention to detail and clear communication are key to meeting the organization's compliance and financial objectives.

What is an HCC Risk Adjustment?

An HCC Risk Adjustment job involves reviewing medical records to ensure accurate coding of diagnoses under the Hierarchical Condition Category (HCC) model. This role helps determine risk scores for patients, which impact healthcare provider reimbursements in Medicare Advantage and other risk-adjusted programs. Professionals in this field, such as medical coders or auditors, analyze documentation to assign appropriate ICD-10-CM codes that reflect a patient's health status. Strong attention to detail and knowledge of coding guidelines are essential for success in this role.

What are the most commonly searched types of Hcc Risk Adjustment jobs in California?

The most popular types of Hcc Risk Adjustment jobs in California are:

What are popular job titles related to Hcc Risk Adjustment jobs in California?

For Hcc Risk Adjustment jobs in California, the most frequently searched job titles are:

What job categories do people searching Hcc Risk Adjustment jobs in California look for?

The top searched job categories for Hcc Risk Adjustment jobs in California are:

What cities in California are hiring for Hcc Risk Adjustment jobs?

Cities in California with the most Hcc Risk Adjustment job openings:

Hcc Risk Adjustment jobs near you
Infographic showing various Hcc Risk Adjustment job openings in California as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 9% Part Time, 2% Temporary, and 2% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $140,459 per year, or $67.5 per hour.

Risk Adjustment Coding Specialist II

Astrana Health, Inc.

Orange, CA • On-site

$70K - $85K/yr

Other

Posted 10 days ago

Job description

Risk Adjustment Coding Specialist II
Department: Quality - Risk Adjustment
Employment Type: Full Time
Location: 600 City Parkway West 10th Floor, Orange, CA 92868
Reporting To: Yuvone Washington-Oshon
Compensation: $70,000 - $85,000 / year
Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. The staff is required to frequently travel to provider sites depending on projects.
Our Values:
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team
What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Meets or exceeds productivity targets as established by management. Regularly meets due dates assigned
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Keeps management apprised of project activities through regular written and oral status reports. Proactively identifies risks that may hinder project success.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS) and/or Certified Professional Coder (CPC). Certified Risk Adjustment Coder (CRC) is a plus but not required
  • 3+ years experience in risk adjustment coding and/or billing experience required
  • Reliable transportation/Valid Driver's License/Must be able to travel at least 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and PowerPoint
  • Excellent presentation, verbal and written communication skills, and ability to collaborate
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.
You're great for the role if:
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Ability to work independently and collaborate in a team setting
  • Strong organizational and time-management skills
  • Ability to work in a home office for continuous periods of time for business continuity
  • Ability to travel across the Provider Clinic service region for meetings and/or training as needed
  • Able to work independently and within time constraints
  • Able to efficiently prioritize multiple high-priority tasks
Environmental Job Requirements and Working Conditions
  • This position blends on-site fieldwork (approximately 75% travel) with remote support to help practices. The Company reserves the right to modify the work arrangement, including transitioning to a hybrid or onsite model, based on business needs. Disclaimer: This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all responsibilities, duties, or qualifications required. Responsibilities may change based on business needs and organizational priorities.
  • The national target pay range for this role is $70,000 - $85,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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