Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...
Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...
Risk Adjustment Analyst
Doral, FL · On-site
Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...
Risk Adjustment Analyst
Doral, FL · On-site
Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models * Familiarity with HEDIS and MSSP Quality Reporting PROFESSIONAL COMPETENCIES * Expertise in analytics, statistics, data visualization, or ...
HCC Risk Coder
Leesburg, FL · On-site +1
$16.75 - $22.25/hr
An active CRC (certified risk adjustment coder) or CPC (certified professional coder) preferred. 2. ... MRA), HCC coding documentation guidelines, rules, and regulation. 4. Two years' demonstrated ...
HCC Risk Coder
Leesburg, FL · On-site +1
$16.75 - $22.25/hr
An active CRC (certified risk adjustment coder) or CPC (certified professional coder) preferred. 2. ... MRA), HCC coding documentation guidelines, rules, and regulation. 4. Two years' demonstrated ...
Risk Adjustment Analyst
North Palm Beach, FL · On-site
$65K - $75K/yr
Risk Adjustment Specialist - Primary Care Location: Remote Employment Type: Full-Time Pay : $65K ... Ensure accurate ICD-10-CM and HCC coding based on clinical documentation * Partner with providers ...
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Risk Adjustment Analyst
North Palm Beach, FL · On-site
$65K - $75K/yr
Risk Adjustment Specialist - Primary Care Location: Remote Employment Type: Full-Time Pay : $65K ... Ensure accurate ICD-10-CM and HCC coding based on clinical documentation * Partner with providers ...
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HCC Coder
Lecanto, FL · On-site
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder
Lecanto, FL · On-site
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder
Lecanto, FL · On-site
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder
Lecanto, FL · On-site
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder
Lecanto, FL · On-site
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder
Lecanto, FL · On-site
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder (Lecanto)
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
HCC Coder (Lecanto)
$13.75 - $18.50/hr
The Role We are seeking a proactive and compassionate HCC Coder to join our Primary Care team ... This role is critical to ensuring accurate risk adjustment, complete documentation, and compliance ...
Manager Risk Adjustment Program
Tampa, FL · On-site +1
... HCC (Hierarchical Condition Category) and ICD-10 coding practices. * As a subject matter expert and ... Certified Risk Adjustment Coder (CRC); Certified Coding Specialist (CCS); or Registered Health ...
Manager Risk Adjustment Program
Tampa, FL · On-site +1
... HCC (Hierarchical Condition Category) and ICD-10 coding practices. * As a subject matter expert and ... Certified Risk Adjustment Coder (CRC); Certified Coding Specialist (CCS); or Registered Health ...
Medicare Risk Adjustment Specialist - Medical Assistant
$16.50 - $20.75/hr
... Risk Adjustment Specialist. ESSENTIAL JOB FUNCTIONS: * Reviews medical record and claims ... HCC & HHS-HCC) models * Abstract all risk adjusted diagnosis codes from acceptable provider ...
Medicare Risk Adjustment Specialist - Medical Assistant
$16.50 - $20.75/hr
... Risk Adjustment Specialist. ESSENTIAL JOB FUNCTIONS: * Reviews medical record and claims ... HCC & HHS-HCC) models * Abstract all risk adjusted diagnosis codes from acceptable provider ...
Medicare Risk Adjustment Specialist - Medical Assistant
Jacksonville, FL · On-site
$16.50 - $20.75/hr
... Risk Adjustment Specialist. ESSENTIAL JOB FUNCTIONS: * Reviews medical record and claims ... HCC & HHS-HCC) models * Abstract all risk adjusted diagnosis codes from acceptable provider ...
Medicare Risk Adjustment Specialist - Medical Assistant
Jacksonville, FL · On-site
$16.50 - $20.75/hr
... Risk Adjustment Specialist. ESSENTIAL JOB FUNCTIONS: * Reviews medical record and claims ... HCC & HHS-HCC) models * Abstract all risk adjusted diagnosis codes from acceptable provider ...
Physician Advisor - Strategic Quality Performance
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment in addition to Diagnosis Related Group (DRG) assignment. * Perform concurrent and retrospective reviews of selected health records as it pertains to CDI and coding validation, and ...
Physician Advisor - Strategic Quality Performance
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment in addition to Diagnosis Related Group (DRG) assignment. * Perform concurrent and retrospective reviews of selected health records as it pertains to CDI and coding validation, and ...
Certified Risk Adjustment Coder
Hialeah, FL · On-site
$20.50 - $27.75/hr
Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... Demonstrates understanding of risk adjustment payment models * Uses clinical reasoning and critical ...
Certified Risk Adjustment Coder
Hialeah, FL · On-site
$20.50 - $27.75/hr
Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... Demonstrates understanding of risk adjustment payment models * Uses clinical reasoning and critical ...
HCC Coding Educator
Fort Myers, FL · Remote
$27.57 - $35.84/hr
Shift 1/ to Minimum to Midpoint Pay Rate: $27.57 - $35.84 / hour Summary The HCC Coding Educator is responsible for improving the accuracy, completeness, and compliance of risk-adjustment ...
HCC Coding Educator
Fort Myers, FL · Remote
$27.57 - $35.84/hr
Shift 1/ to Minimum to Midpoint Pay Rate: $27.57 - $35.84 / hour Summary The HCC Coding Educator is responsible for improving the accuracy, completeness, and compliance of risk-adjustment ...
Certified Risk Adjustment Coder
$20.50 - $27.75/hr
Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... Demonstrates understanding of risk adjustment payment models * Uses clinical reasoning and critical ...
Certified Risk Adjustment Coder
$20.50 - $27.75/hr
Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports * Queries and ... Demonstrates understanding of risk adjustment payment models * Uses clinical reasoning and critical ...
HCC Coding Educator
Fort Myers, FL · On-site +1
$27.57 - $35.84/hr
Shift 1/ to Minimum to Midpoint Pay Rate: $27.57 - $35.84 / hour Summary The HCC Coding Educator is responsible for improving the accuracy, completeness, and compliance of risk-adjustment ...
HCC Coding Educator
Fort Myers, FL · On-site +1
$27.57 - $35.84/hr
Shift 1/ to Minimum to Midpoint Pay Rate: $27.57 - $35.84 / hour Summary The HCC Coding Educator is responsible for improving the accuracy, completeness, and compliance of risk-adjustment ...
Physician Advisor - Strategic Quality Performance
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment in addition to Diagnosis Related Group (DRG) assignment. * Perform concurrent and retrospective reviews of selected health records as it pertains to CDI and coding validation, and ...
Physician Advisor - Strategic Quality Performance
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment in addition to Diagnosis Related Group (DRG) assignment. * Perform concurrent and retrospective reviews of selected health records as it pertains to CDI and coding validation, and ...
Physician Advisor - Strategic Quality Performance - Onsite
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment, CMI and the impact of clinical documentation/coding in relation to these metrics. - Excellent computer skills with prior exposure to use of Microsoft Office suite Position ...
Physician Advisor - Strategic Quality Performance - Onsite
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment, CMI and the impact of clinical documentation/coding in relation to these metrics. - Excellent computer skills with prior exposure to use of Microsoft Office suite Position ...
Physician Advisor - Strategic Quality Performance - Onsite
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment, CMI and the impact of clinical documentation/coding in relation to these metrics. - Excellent computer skills with prior exposure to use of Microsoft Office suite Position ...
Physician Advisor - Strategic Quality Performance - Onsite
Lakeland, FL · On-site
$161K - $215K/yr
... HCC/risk adjustment, CMI and the impact of clinical documentation/coding in relation to these metrics. - Excellent computer skills with prior exposure to use of Microsoft Office suite Position ...
Stays current on coding guidelines, risk adjustment reimbursement requirements, and changes to the CMS-HCC model; * Generates client deliverables and make valuable contributions to expert reports;
Stays current on coding guidelines, risk adjustment reimbursement requirements, and changes to the CMS-HCC model; * Generates client deliverables and make valuable contributions to expert reports;
Hcc Risk Adjustment information
See Florida salary details
$8.2K - $20.4K
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$20.4K - $32.5K
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$96.7K is the 25th percentile. Wages below this are outliers.
$93.3K - $105.5K
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$105.5K - $117.7K
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$129.8K - $142K
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How much do hcc risk adjustment jobs pay per year?
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 job?
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.

Job description
SCOPE OF ROLEÂ
The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting. The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.
This is an onsite position in Doral, FL.
ROLE RESPONSIBILITIES
- Proactively collaborate and interact with business stakeholders across the organization to understand analytics needs, develop plans to address those needs, and deliver analytics to meet those needs.
- Using SQL code, mine data on medical spend, clinical data and population health data and derive meaningful insights to improve operations such as trends, correlations and patterns.
- Own the data. You are responsible for accurate presentation of your data elements, so ensuring data integrity is paramount.
- Thoroughly analyze data, quickly identify relevant information, and transform it into a meaningful output. Â Conduct thoughtful presentations, online or in person, to stakeholders with actionable findings for improvement.
- Provide concise data reports and clear data visualizations for executive level reporting through Power BI, Excel and other tools used by the organization.
- Create data processes that are consistent, repeatable, and scalable.
- Conduct Quarterly Reconciliations to identify dropped HCCs and prepare supplemental data submission files according to payor partner specifications.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Bachelor's degree is required.
- Comprehensive understanding of risk adjustment and quality programs across all government-regulated lines of business, including Marketplace, Medicaid, and Medicare programs.
- Five (5) or more years of hands-on SQL code development is required, including expertise with programming languages like Scala or Python.
- Three (3) or more years of experience in healthcare field dealing with claims/utilization as it pertains to Risk Adjustment and Quality.
- Three (3) or more years of analytics experience (Required)
- Two (2) or more years of Power BI experience (Required)
- Experience with Databricks (Preferred)
- Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models
- Familiarity with HEDIS and MSSP Quality Reporting
PROFESSIONAL COMPETENCIES
- Expertise in analytics, statistics, data visualization, or programming
- Dedicates exacting attention to detail and data quality
- Eager learner, collaborative partner, easy communicator, and careful analyst
- Passion for empirical research and answering hard questions with data
About Centrum Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
Miami, FL, US