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Hcc Risk Adjustment Jobs in Virginia (NOW HIRING)

DaMar Staffing

Risk Adjustment Coder

Virginia Beach, VA · On-site

$90 - $110/hr

Prefer previous experience with CMS, HHS and/or CDPS+RX Hierarchical Condition Categories (HCC) models. Prefer previous CMS and/or HHS Risk Adjustment Data Validation (RADV) experience. Benefits ...

Sentara Health

Risk Adjustment Coder

Virginia Beach, VA · Hybrid

$10K/mo

... HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual ...

Ennoble Care

Sr. Medical Economics Analyst

Arlington, VA · Remote

$120K - $140K/yr

Conduct comprehensive claims analysis using CCLF (Claims and Claims Line Feed) and BCDA (Beneficiary Claims Data API) datasets, including simulating CMS-HCC risk adjustment. Data Management ...

Albanymed

Senior Professional Coder

Broadway, VA · Remote

$64K - $97K/yr

Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require onsite education to providers as needed. Essential Duties and Responsibilities * Review, analyze, and ...

DaMar Staffing

IPA Consultative Coder

Newport News, VA · On-site

$59 - $81/hr

HCC Outage and Recapture Support * Support HCC outage management through structured reviews of ... Required Qualifications: * 3+ years of risk adjustment Medical Coding or risk adjustment Provider ...

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Hcc Risk Adjustment information

See Virginia salary details

$10.9K

$141.1K

$188.4K

How much do hcc risk adjustment jobs pay per year?

As of Sep 5, 2026, the average yearly pay for hcc risk adjustment in Virginia is $141,102.00, according to ZipRecruiter salary data. Most workers in this role earn between $131,400.00 and $131,400.00 per year, depending on experience, location, and employer.

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 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 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 most commonly searched types of Hcc Risk Adjustment jobs in Virginia?

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

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

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

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

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

Hcc Risk Adjustment jobs near you
Infographic showing various Hcc Risk Adjustment job openings in Virginia as of August 2026, with employment types broken down into 78% Full Time, and 22% Contract. Highlights an 49% In-person, and 51% Remote job distribution, with an average salary of $141,102 per year, or $67.8 per hour.

Risk Adjustment Coder

Sentara Healthcare Inc

Virginia Beach, VA • On-site

$60 - $80/hr

Other

Posted 4 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

497th of 898 rated healthcare providers

Job description

Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!

Hours: Monday - Friday, 8:00AM -5:00PM, dayshift.

This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration.

Overview

Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality oversight audits; reviews and/or makes final coding determination for non-agreeable coding. Makes final decision on vendor-to-vendor diagnosis coding rebuttal concerns. Serves as subject matter expert on risk adjustment diagnosis coding guidelines. Coordinates risk adjustment gap elimination with clinical and quality gap elimination Maintains a reasonable fluency in workings & financial implications of applicable risk adjustment models.

Education
  • Associate degree (Required)
Experience
  • Medical Records Data - 1 year (Required)
  • Coding - 2 years (Required)
Certifications:

One of the following certifications are required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist-Physician-based (CCS-P), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).

Must obtain Certified Risk Adjustment Coder (CRC) certification within two years of employment.

Keywords:

Risk Adjustment Coding & Documentation Specialist, Talroo-Allied Health, Medical Office

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