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Hcc Risk Adjustment Jobs in Texas (NOW HIRING)

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 (Accreditation) 4. And more These are a remote/home based temporary positions forecast to run through the ...

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 (Accreditation) 4. And more These are a remote/home based temporary positions forecast to run through the ...

St Luke's Health

Value Based Coder II

Houston, TX · On-site

$25.30 - $35.74/hr

Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. 3. Compliance & Regulatory Insight: Continuously monitor and interpret ...

CommonSpirit Health

Value Based Coder II

Houston, TX · On-site

$18 - $23.75/hr

Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. 3. Compliance & Regulatory Insight: Continuously monitor and interpret ...

St. Luke's Health

Value Based Coder II

Houston, TX · On-site +1

$25.30 - $35.74/hr

Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. 3. Compliance & Regulatory Insight: Continuously monitor and interpret ...

Catholic Health Initiatives

Value Based Coder II

Houston, TX · On-site

$25.30 - $35.74/hr

Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. * Compliance & Regulatory Insight: Continuously monitor and interpret evolving ...

St Luke's Health

Value Based Coder II

Houston, TX

$25.30 - $35.74/hr

Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles. 3. Compliance & Regulatory Insight: Continuously monitor and interpret ...

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All JobsHcc Risk Adjustment JobsHcc Risk Adjustment Jobs in Texas

Hcc Risk Adjustment information

See Texas salary details

$10.2K

$132.6K

$177K

How much do hcc risk adjustment jobs pay per year?

As of Jul 2, 2026, the average yearly pay for hcc risk adjustment in Texas is $132,595.00, according to ZipRecruiter salary data. Most workers in this role earn between $123,400.00 and $123,400.00 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 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.

What are the most commonly searched types of Hcc Risk Adjustment jobs in Texas? The most popular types of Hcc Risk Adjustment jobs in Texas are:
What are popular job titles related to Hcc Risk Adjustment jobs in Texas? For Hcc Risk Adjustment jobs in Texas, the most frequently searched job titles are:
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Hcc Risk Adjustment jobs near you

Risk Adjustment Coding Specialist II - Houston

Astrana Health, Inc.

Houston, TX • On-site, Remote

$70K - $85K/yr

Full-time

Posted 8 days ago

Job description

Risk Adjustment Coding Specialist II - Houston
Department: Quality - Risk Adjustment
Employment Type: Full Time
Location: 19500 HWY 249, Suite 570 Houston, TX 77070
Reporting To: Chanell Graves
Compensation: $70,000 - $85,000 / year
Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You'll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! This position requires travel to provider offices up to 75% of the time in the Houston area.
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
  • 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.
  • 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
  • Other duties as assigned

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC certification, CPC and CRC.
  • At least 3 years of experience in risk adjustment coding and/or billing experience required.
  • At least 1 year of experience with targeted provider education.
  • Reliable transportation/Valid Driver's License/Must be able to travel up to 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • 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 this role if:
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybridwork structure where the expectation is to work in the office, in the field and at home on a weekly basis. 19500 HWY 249, Suite 570 Houston, TX 77070. This position requires up to 75% travel to provider offices in Houston.

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.comto 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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