Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...
Conduct compliance risk assessments related to coding, documentation, and encounter data ... Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly ...
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
Head of Medicare Performance Hub
Chicago, IL · On-site
$198 - $278/hr
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
Head of Medicare Performance Hub
Chicago, IL · On-site
$198 - $278/hr
CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...
Physician Assistant or Nurse Practitioner - Thoracic Surgery, Quality, Clinical Documentation (Ou...
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Physician Assistant or Nurse Practitioner - Thoracic Surgery, Quality, Clinical Documentation (Ou...
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Physician Assistant or Acute Care Nurse Practitioner - Thoracic Surgery, Quality, Clinical Docume...
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Physician Assistant or Acute Care Nurse Practitioner - Thoracic Surgery, Quality, Clinical Docume...
CPT coding for thoracic surgical procedures * Elixhauser and Charlson comorbidity indices * CMS Star Rating, Leapfrog Hospital Safety Grade, AHRQ PSIs, and CMS HACs * CMS-HCC and Risk Adjustment ...
Director, Coding
Chicago, IL · Remote
Must be Certified Coder (AAPC or AHIMA) * Experience with encoders and computerized abstracting ... Knowledge and experience of Medicare Risk Adjustment guidelines
Director, Coding
Chicago, IL · Remote
Must be Certified Coder (AAPC or AHIMA) * Experience with encoders and computerized abstracting ... Knowledge and experience of Medicare Risk Adjustment guidelines
Medicare Plan Management Principal
Chicago, IL · On-site
$142 - $192/hr
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Medicare Plan Management Principal
Chicago, IL · On-site
$142 - $192/hr
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Medicare Plan Management Principal
Chicago, IL · On-site
$142 - $192/hr
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Medicare Plan Management Principal
Chicago, IL · On-site
$142 - $192/hr
Deep familiarity with Medicare Advantage program structure, including CMS Star Ratings, Risk Adjustment (RAF/HCC), and medical cost management strategies; knowledge of FEHBP and FEP program structure ...
Physician Assistant or Nurse Practitioner - Thoracic Surgery, Quality, Clinical Documentation ([...]
Chicago, IL · On-site
$110 - $180/hr
Engage with PB Coding, Inpatient coding, and Rev Cycles at NM * Engage with Physician and APP ... CMS‑HCC and Risk Adjustment Factor (RAF) B. Independent Documentation Refinement After Physician ...
Physician Assistant or Nurse Practitioner - Thoracic Surgery, Quality, Clinical Documentation ([...]
Chicago, IL · On-site
$110 - $180/hr
Engage with PB Coding, Inpatient coding, and Rev Cycles at NM * Engage with Physician and APP ... CMS‑HCC and Risk Adjustment Factor (RAF) B. Independent Documentation Refinement After Physician ...
Sr. Associate, Medical Economics
$94K - $120K/yr
... new code and mappings, and change management. * Own the ongoing maintenance, enhancements ... risk adjustment data to explain population-level trends and financial performance. * Work with ...
Sr. Associate, Medical Economics
$94K - $120K/yr
... new code and mappings, and change management. * Own the ongoing maintenance, enhancements ... risk adjustment data to explain population-level trends and financial performance. * Work with ...
Nurse Practitioner
Schererville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Schererville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Chicago, IL · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Chicago, IL · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Chicago, IL · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Chicago, IL · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Merrillville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Merrillville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Merrillville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Merrillville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Schererville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Schererville, IN · On-site
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Director, Revenue Accounting
Downers Grove, IL · On-site
$125K - $188K/yr
Partner with Revenue Cycle to ensure accurate charge capture, coding, billing, and collections ... Lead accounting for shared savings, downside risk, quality bonuses, risk adjustment, and ...
Director, Revenue Accounting
Downers Grove, IL · On-site
$125K - $188K/yr
Partner with Revenue Cycle to ensure accurate charge capture, coding, billing, and collections ... Lead accounting for shared savings, downside risk, quality bonuses, risk adjustment, and ...
Nurse Practitioner
Schererville, IN · On-site
$112K - $140K/yr
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Nurse Practitioner
Schererville, IN · On-site
$112K - $140K/yr
Accurately documents and captures diagnoses to support risk adjustment (HCC coding), identify and address care gaps related to HEDIS and preventative care. * Presents patient cases and provides ...
Internship Hcc Risk Adjustment Coder information
See Chicago, IL salary details
$26.3K - $32.1K
5% of jobs
$34.1K is the 25th percentile. Wages below this are outliers.
$32.1K - $38K
59% of jobs
$38K - $43.8K
9% of jobs
$44.3K is the 75th percentile. Wages above this are outliers.
$43.8K - $49.7K
17% of jobs
$49.7K - $55.5K
4% of jobs
$55.5K - $61.4K
2% of jobs
$61.4K - $67.2K
3% of jobs
$67.2K - $73.1K
0% of jobs
$73.1K - $78.9K
0% of jobs
$78.9K - $84.8K
0% of jobs
$84.8K - $90.7K
0% of jobs
$26.3K
$43.9K
$90.7K
How much do internship hcc risk adjustment coder jobs pay per year?
What is the difference between Internship Hcc Risk Adjustment Coder vs Hcc Risk Adjustment Coder?
| Aspect | Internship Hcc Risk Adjustment Coder | Hcc Risk Adjustment Coder |
|---|---|---|
| Credentials | Typically none or basic certifications | Certifications like CPC, CCS, or RHIT often required |
| Work Environment | Internship setting, training-focused | Full-time professional setting, independent work |
| Employer & Industry | Hospitals, healthcare providers, training programs | Healthcare organizations, insurance companies |
| Search & Comparison Intent | Learning, entry-level roles, training | Professional, experienced roles, career advancement |
The Internship Hcc Risk Adjustment Coder is an entry-level position designed for training and gaining experience, often without requiring certifications. In contrast, the Hcc Risk Adjustment Coder is a full-time professional role that typically requires relevant certifications and experience. Both roles are within the healthcare industry, but they differ significantly in responsibilities, expectations, and career progression.
What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Chicago, IL?
The most popular types of Hcc Risk Adjustment Coder jobs in Chicago, IL are:
What are popular job titles related to Internship Hcc Risk Adjustment Coder jobs in Chicago, IL?
For Internship Hcc Risk Adjustment Coder jobs in Chicago, IL, the most frequently searched job titles are:
What job categories do people searching Internship Hcc Risk Adjustment Coder jobs in Chicago, IL look for?
The top searched job categories for Internship Hcc Risk Adjustment Coder jobs in Chicago, IL are:
What cities near Chicago, IL are hiring for Internship Hcc Risk Adjustment Coder jobs?
Cities near Chicago, IL with the most Internship Hcc Risk Adjustment Coder job openings:
Senior Manager, Corporate Compliance - Risk Adjustment
Northbrook, IL
5.8
Based on 4,355 frontline employees who took The Breakroom Quiz
91st of 113 rated pharmacies
Recommended by students
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Respectful managers
Uninterrupted breaks
$75K - $165K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 8 days ago
Job description
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.
The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.
Key Responsibilities
Lead the Medicare Advantage Risk Adjustment compliance program.
Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.
Assess operational processes for compliance risks related to risk adjustment activities.
Develop and implement corrective action plans for identified compliance issues.
Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.
Required Qualifications
Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance
Minimum 5 years in a leadership role
One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)
Willingness to travel up to 10% (including by plane)
Preferred Qualifications
Health Information Management (RHIA/RHIT)
Nursing - Strong understanding of clinical documentation and medical record review
Certified Risk Adjustment Coder (CRC) with compliance experience
Provider coding audit/compliance leadership experience
Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits
Education
Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
About CVS Health
Sourced by ZipRecruiter
Industry
Health care and social assistance and retail
Company size
10,000+ Employees
Headquarters location
Woonsocket, RI, US
Website
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Benefits
Hours and flexibility
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