ZipRecruiter

Log In

1

Permanent Hcc Risk Adjustment Jobs in Georgia (NOW HIRING)

Urrly

Telehealth Nurse Practitioner

Atlanta, GA · Remote

$600 - $720/day

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

Tmhcc

Associate Sales Representative

Kennesaw, GA · Hybrid

$74K - $112K/yr

... adjustments, where applicable. The pay range is the range THMCC, in good faith, believes is ... HCC.Applying our Mind Over Risk philosophy to writing insurance allows our customers to take on ...

Kaiser Permanente

RN, Targeted Review

Atlanta, GA · On-site

$40.35/hr

... makes adjustments based on findings. Remains knowledgeable of contract benefits and current ... Risk Management and Kaiser Permanents medical offices to facilitate the precertification and ...

next page

Showing results 1-20

All JobsPermanent Hcc Risk Adjustment JobsPermanent Hcc Risk Adjustment Jobs in Georgia

Permanent Hcc Risk Adjustment information

What is the difference between Permanent Hcc Risk Adjustment vs Permanent Hcc Risk Adjustment?

AspectPermanent Hcc Risk Adjustment

It appears there is a duplication in the comparison question. Assuming the intended comparison is between Permanent Hcc Risk Adjustment and Hcc Coding Specialist, here is the comparison:

AspectPermanent Hcc Risk Adjustment

Permanent Hcc Risk Adjustment involves analyzing and managing patient data to ensure accurate risk scores for insurance purposes, requiring knowledge of medical coding, risk models, and healthcare regulations. An Hcc Coding Specialist focuses on assigning correct diagnosis codes to patient records, often working in similar environments with certifications like CPC. Both roles are essential in healthcare reimbursement and share similar credentials, work settings, and industry usage, but the Risk Adjustment role emphasizes data analysis and risk management, while Coding Specialists focus on accurate coding documentation.

What are popular job titles related to Permanent Hcc Risk Adjustment jobs in Georgia? For Permanent Hcc Risk Adjustment jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Permanent Hcc Risk Adjustment jobs in Georgia look for? The top searched job categories for Permanent Hcc Risk Adjustment jobs in Georgia are:
What cities in Georgia are hiring for Permanent Hcc Risk Adjustment jobs? Cities in Georgia with the most Permanent Hcc Risk Adjustment job openings:
Permanent Hcc Risk Adjustment jobs near you
Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only

Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only

Pantar Solutions inc

Atlanta, GA • On-site

Contractor

Posted 23 days ago

Job description

We are an Information Technology and Business Consulting firm specializing in Project-based Solutions and Professional Staffing Services. Please have a look at below position which is with our Client and let me know your interest ASAP. I would really appreciate if you could send me your MOST RECENT UPDATED RESUME: 

Title: Business Analyst – Risk Adjustment (Payor)

Location: Richmond or Atlanta  – Hybrid role

Long Term Contract || 1099 only || Need USC or GC only

Need strong Business Analyst – Risk Adjustment (Payor) with  risk adjustment analytics in a healthcare payer environment (Medicare Advantage, ACA (HIX/Exchange), or Medicaid), SQL, Excel, data visualization tools (Tableau/Power BI/SAS), healthcare data formats (claims, encounters, EMR, lab, and eligibility), regulatory processes (CMS, HHS, EDGE server, RADV/IVA audits), HCC coding models (CMS-HCC, HHS-HCC), ICD-10 codes, and claims data Exp.

Consultant LinkedIn profile must have been created before 2018/2019

Need 8-10+yrs of IT Exp. Profiles

Job Summary:Client is seeking a highly analytical and motivated Business Analyst – Risk Adjustment to support risk adjustment operations and data analytics initiatives. This role is critical in helping ensure accurate and compliant capture of risk adjustment data for government-sponsored programs such as Medicare Advantage and ACA (HIX/Exchange). The candidate will play a key role in translating business needs into technical solutions, driving insights, and enabling optimized risk scoring strategies.
Key Responsibilities:

  • Analyze and interpret risk adjustment data (claims, encounters, chart reviews, HCCs) to identify trends, data quality issues, and improvement opportunities.

  • Collaborate with stakeholders across actuarial, clinical coding, IT, and compliance teams to support risk score accuracy.

  • Translate regulatory and business requirements into user stories or functional specifications for data/reporting solutions.

  • Support CMS/HHS risk adjustment submission processes including EDGE server management and encounter reconciliation.

  • Assist in development and enhancement of dashboards/reports for risk score monitoring, suspecting models, and provider performance.

  • Monitor and interpret changes in CMS/HHS risk adjustment guidelines and apply to internal business processes.

  • Participate in audit support (e.g., RADV, IVA) and validation of risk adjustment data submissions.

  • Act as liaison between technical teams and business stakeholders to ensure delivery of actionable and scalable solutions.

Qualifications:

  • Bachelor's degree in Healthcare Administration, Business, Analytics, or related field (Master’s preferred).

  • 8+ years of experience in risk adjustment analytics in a healthcare payer environment (Medicare Advantage, Medicaid, or ACA).

  • Strong knowledge of HCC models (CMS-HCC, HHS-HCC), ICD-10 coding, and risk adjustment methodologies.

  • Experience with healthcare data formats: claims, encounters, EMR, lab, and eligibility.

  • Proficiency in SQL and Excel; experience with BI tools like Power BI, Tableau, or SAS preferred.

  • Familiarity with regulatory processes (CMS, HHS, EDGE server, RADV/IVA audits).

Preferred Skills:

  • Knowledge of data and reporting tools, including Cognos or Watson Health platforms.

  • Experience in Agile environments; ability to write and manage JIRA user stories and tasks.

  • Strong communication and stakeholder engagement skills across technical and business teams.

 
Thanks & Regards,
 
Babu