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Non Union Hcc Risk Adjustment Jobs (NOW HIRING)

Gather Health

Risk Adjustment Coding Specialist

Boston, MA · On-site

$65K - $85K/yr

With deep expertise in the CMS-HCC Risk Adjustment Payment Model (V28), Hierarchical Condition Category (HCC) and CPT coding, the Specialist will serve as a trusted partner to providers, offering 1:1 ...

Gather Health

Risk Adjustment Coding Specialist

Boston, MA · On-site

$65K - $85K/yr

With deep expertise in the CMS-HCC Risk Adjustment Payment Model (V28), Hierarchical Condition Category (HCC) and CPT coding, the Specialist will serve as a trusted partner to providers, offering 1:1 ...

PedIM Healthcare

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 ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$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 ...

Gather Health

Risk Adjustment Coding Specialist

Boston, MA · On-site

$65K - $85K/yr

With deep expertise in the CMS-HCC Risk Adjustment Payment Model (V28), Hierarchical Condition Category (HCC) and CPT coding, the Specialist will serve as a trusted partner to providers, offering 1:1 ...

Pedim

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 ...

PedIM Healthcare

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 ...

PedIM Healthcare

HCC Coder

Lecanto, FL

$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 ...

Guidehouse

Remote Risk Adjustment Medical Coder

$44K - $74K/yr

High School Diploma or equivalent * 3+ years HCC Risk Adjustment Coding. * CPC or CRC certification from AAPC * EMR experience * Must maintain credential throughout employment * Strong working ...

Guidehouse

Remote Risk Adjustment Medical Coder

OR · Remote

$44K - $74K/yr

High School Diploma or equivalent * 3+ years HCC Risk Adjustment Coding. * CPC or CRC certification from AAPC * EMR experience * Must maintain credential throughout employment * Strong working ...

PedIM Healthcare

HCC Coder (Lecanto)

Lecanto, FL

$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 ...

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All JobsNon Union Hcc Risk Adjustment Jobs

Non Union Hcc Risk Adjustment information

Is HCC coding a good career?

HCC coding, particularly in risk adjustment roles like Non Union HCC Risk Adjustment, is a growing field with steady demand due to the expansion of value-based healthcare. It requires knowledge of medical coding, clinical documentation, and often involves working with electronic health records; certifications such as CPC or CCS can enhance job prospects. The role offers opportunities for specialization and career advancement within healthcare administration and coding departments.

What is the difference between Non Union Hcc Risk Adjustment vs Non Union Medical Coder?

AspectNon Union Hcc Risk AdjustmentNon Union Medical Coder
CredentialsCertifications in risk adjustment, coding, or healthcare analyticsMedical coding certifications (CPC, CCS, etc.)
Work EnvironmentInsurance companies, healthcare analytics firms, or risk adjustment departmentsHospitals, clinics, or medical billing companies
Industry UsageFocuses on risk scoring for insurance reimbursement and healthcare planningFocuses on translating medical records into codes for billing and documentation

Non Union Hcc Risk Adjustment specialists primarily analyze health data to optimize risk scores for insurance purposes, while Non Union Medical Coders focus on accurately coding medical records for billing. Both roles require healthcare certifications but differ in their core functions and work settings.

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Non Union Hcc Risk Adjustment jobs near you

Risk Adjustment Specialist

LSMA Management Inc

San Bernardino, CA • On-site

$30 - $34/hr

Full-time

Posted 26 days ago

Job description

Job Type
Full-time
Description
JOB SUMMARY
The Risk Adjustment Specialist - Coding Compliance supports the organization's delegated Risk Adjustment and Coding Compliance programs by performing specialized audit support, documentation review coordination, coding validation support, medical record analysis, and compliance activities to promote accurate and complete Hierarchical Condition Category (HCC) capture in accordance with Centers for Medicare & Medicaid Services (CMS), California Department of Managed Health Care (DMHC), National Committee for Quality Assurance (NCQA), Office of Inspector General (OIG), and contracted health plan requirements.
This role supports coding compliance oversight activities related to Medicare Advantage Risk Adjustment, Risk Adjustment Data Validation (RADV), provider documentation integrity, and coding accuracy initiatives. The position assists with identifying documentation gaps, monitoring coding compliance trends, coordinating audit preparation activities, and supporting provider education efforts to ensure accurate Risk Adjustment Factor (RAF) scoring and regulatory compliance.
The Risk Adjustment Specialist collaborates closely with Coding Compliance leadership, certified coders, providers, population health teams, utilization management, care management, quality improvement, and health plans to support compliant documentation and coding practices, audit readiness, and delegated risk adjustment program performance.
Requirements
MINIMUM & PREFERRED QUALIFICATIONS:
Education/Training
Minimum: High school diploma or GED equivalent required
Preferred: Associate's degree or higher in healthcare administration, public health, social services, or related field.
Experience
Minimum: At least one year of experience in one or more of the following areas: risk adjustment, coding compliance, medical record review, managed care, healthcare administration, managed care or MSO environment, medical office or provider operations.
Preferred: Experience supporting Medicare Advantage Risk Adjustment programs. Experience supporting CMS RADV audits or coding compliance audits. Experience in an MSO, IPA, health plan, delegated entity, or managed care environment. Experience working with electronic health records, coding software, or Risk Adjustment platforms.
Certification(s)
Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other coding certification preferred.
Skills, Knowledge & Abilities
  • Knowledge of CMS Risk Adjustment methodology, HCC documentation requirements, and RAF score principles.
  • Understanding of Medicare Advantage Risk Adjustment, coding compliance, and documentation integrity requirements.
  • Familiarity with CMS RADV audit standards, DMHC regulatory requirements, NCQA standards, and delegated health plan oversight requirements.
  • Ability to identify documentation deficiencies, coding inconsistencies, compliance risks, and audit-related concerns.
  • Strong organizational, analytical, auditing, and data tracking skills with exceptional attention to detail and accuracy.
  • Ability to maintain accurate records, audit logs, compliance documentation, and reporting tools.
  • Proficiency with electronic health records, Risk Adjustment platforms, coding software, and Microsoft Office applications.
  • Strong verbal and written communication skills with the ability to communicate professionally with providers, coders, leadership, health plans, and interdisciplinary teams.
  • Ability to handle confidential and sensitive information in compliance with HIPAA and organizational policies.
  • Ability to manage multiple priorities, deadlines, and audit-related activities in a fast-paced managed care environment.
  • Ability to work independently while collaborating effectively within interdisciplinary operational and compliance teams.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS:
The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. Primarily sedentary work involving prolonged computer use. Occasional standing, walking, and local travel may be required. Ability to lift up to 20 pounds occasionally. Requires strong attention to detail, data analysis capability, and effective communication skills. Work is performed in an office or remote environment supporting electronic medical record and Risk Adjustment systems.
PAY RANGE
$30.00 - $34.00 / hourly
Salary Description
$30.00 - $34.00 / hourly

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