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Remote Hcc Risk Adjustment Coder Jobs in Michigan

Tmhcc

Underwriter

Troy, MI · On-site +1

... HCC - Public Risk Group, a member of the Tokio Marine group of companies, is a market leader in ... Remote

M&Y CARE LLC

Occupational Therapist

West Bloomfield, MI · Remote

$3.0K - $6.0K/mo

Remote Therapeutic Monitoring (RTM): * Utilize RTM technology to monitor and manage patient progress remotely. * Ensure compliance with RTM CPT codes and Medicare billing requirements. Outpatient ...

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Remote Hcc Risk Adjustment Coder information

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How much do remote hcc risk adjustment coder jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for remote hcc risk adjustment coder in Michigan is $19.67, according to ZipRecruiter salary data. Most workers in this role earn between $15.96 and $20.96 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote HCC Risk Adjustment Coder, and why are they important?

To thrive as a Remote HCC Risk Adjustment Coder, you need a solid understanding of ICD-10-CM coding guidelines, risk adjustment models, and extensive experience in medical record review, typically supported by a relevant coding certification such as CPC or CRC. Proficiency with electronic health record (EHR) systems, coding software, and risk adjustment platforms is essential. Exceptional attention to detail, analytical thinking, and strong communication skills help coders excel in remote settings and ensure coding accuracy. These skills and qualifications are vital for optimizing risk scores, ensuring compliance, and supporting accurate reimbursement in healthcare organizations.

What is a Remote HCC Risk Adjustment Coder?

A Remote HCC Risk Adjustment Coder is a medical coding professional who works from home or another remote location, reviewing patient medical records to assign Hierarchical Condition Category (HCC) codes. These codes are used by healthcare organizations to accurately reflect the severity of patient illnesses for risk adjustment and reimbursement purposes, especially in Medicare Advantage programs. The coder analyzes clinical documentation to ensure that diagnoses are coded correctly and in compliance with regulatory guidelines. Their work is essential for ensuring healthcare providers receive appropriate compensation and for maintaining accurate patient risk profiles.

What are some common challenges faced by remote HCC Risk Adjustment Coders and how can they be managed?

Remote HCC Risk Adjustment Coders often encounter challenges such as interpreting incomplete or ambiguous medical documentation, staying updated with evolving coding guidelines, and managing communication across dispersed teams. To address these challenges, it's important to proactively seek clarification from providers, participate in ongoing training, and utilize collaboration tools to stay connected with peers and supervisors. Establishing a structured daily workflow and leveraging available resources can also help maintain coding accuracy and productivity in a remote setting.
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Remote Hcc Risk Adjustment Coder jobs near you
Risk Adjustment Compliance Coder

Risk Adjustment Compliance Coder

Upper Peninsula Health Plan

Marquette, MI • Remote

$28.86/hr

Full-time

Posted 12 days ago

Job description

DATE: June 4, 2026POSITION:  Risk Adjustment Compliance CoderDEPARTMENT:  Finance-Risk AdjustmentRATE: $28.86 per hour, with potential for additional compensation based on qualifications. POSITION SUMMARY: 
The Risk Adjustment Compliance Coder is responsible for enhancing the accuracy, quality, and integrity of coding data that supports Medicare and Medicaid reimbursement. This role conducts risk adjustment coding audits, performs compliance research, responds to coding inquiries, and serves as a subject matter expert in risk adjustment coding and compliance. The position supports Medicare and Medicaid risk adjustment programs through the development, implementation, and ongoing evaluation of program initiatives. Highly collaborative and operational in nature, this role partners closely with providers and internal stakeholders and requires strong communication, education, and relationship-management skills. This is not a traditional production-focused coding position. 
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information.
 
2. Collaborates with Risk Adjustment Analyst to develop, implement, and continually refine internal prospective and retrospective chart review programs and related risk adjustment initiatives.
 
3. Follows International Classification of Diseases (ICD)-10 guidelines for Coding and Reporting, Centers for Medicare & Medicaid Services (CMS) risk adjustment guidelines, and demonstrates knowledge of Current Procedural Terminology (CPT) coding. Understands the impact of ICD-10 coding on the CMS Hierarchical Condition Categories (HCC) risk adjustment model, and serves as the subject matter expert for risk adjustment activities.
 
4. Supports risk adjustment compliance and program integrity activities, including RADV preparedness, high-risk diagnosis review and validation, audit support, and identification and escalation of potential coding or documentation compliance concerns.
 
5. Assists with extraction of charts via remote Electronic Medical Record (EMR) access or faxed medical record request for risk adjustment initiatives.
 
6. Performs comprehensive medical record review, verifying and ensuring accuracy, completeness, specificity, and appropriateness of diagnoses codes in accordance with ICD-10 guidelines based on medical record documentation. Documents trends, observations, and potential coding or documentation improvement opportunities identified during the review process.
 
7. Maintains a comprehensive tracking and management tool to track all coding activities; generates and maintains accurate weekly, monthly, and quarterly reports of activities.
 
8. Assists with chart review encounter data submissions to CMS based on chart review findings.
 
9. Provides support during the annual retrospective chart review performed by an external party.
 
10. Identifies, develops, and delivers general and specific educational guidance to providers and clinic staff through webinars, newsletters, presentations, and other educational forums based on risk adjustment audit findings, CMS guidelines, regulatory requirements, and industry best practices.
 
11. Collaborates with internal departments, as appropriate, to carry out risk adjustment program activities to ensure integrity of diagnoses attributed to members submitted to the Michigan Department of Health and Human Services (MDHHS) and CMS by UPHP.
 
12. Collaborates with healthcare leaders, physicians, and provider office personnel to improve the accuracy and completeness of diagnosis code capture. Facilitates provider education, documentation clarification, and coding-related discussions in a professional, consultative manner to support risk adjustment and compliance objectives. 
 
13. Maintains confidentiality of client data.
 
14. Performs other related duties as assigned or requested.
POSITION QUALIFICATIONS:Education:Minimum:
High School Diploma
 Preferred:
Associate degree in business, health information processing, or related field 
 Certification:Minimum:
Must possess and maintain an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification—Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), or Certified Risk Adjustment Coder (CRC)
 Preferred:
Certified Coding Specialist (CCS-P, CCS, CPC) and Certified Risk Adjustment Coder (CRC)
 
Experience:Minimum:
Two (2) years of experience in medical chart coding
 Preferred:
Five (5) years of experience in medical chart coding, including inpatient and outpatient settings; working knowledge of managed care and health plan standards on Risk Adjustment Coding
 
Other Qualifications:
Knowledge and understanding of medical terminology, disease process, and anatomy and physiology
Advanced knowledge and understanding of CPT coding across a wide variety of provider specialties
 Required Skills:
Excellent organizational abilities with attention to detail
Ability to effectively communicate with, and educate, clinic staff (provider, care managers, clinic quality leads, etc.)
Working knowledge of Microsoft Office (Word, Excel, Outlook)
Keyboarding proficiency
Research and analytical skills
 Preferred Skills:
Knowledge of MS PowerPoint
Oriented to managed care
 
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.
 
Physical Requirements: 
[This job requires the ability to perform the essential functions contained in the description. These include, but are not limited to, the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]:
 
Ability to enter and access information from a computer
Occasionally lifts supplies/equipment
Prolonged periods of sitting
Manual dexterity 
 
Working Conditions:
Position available onsite (in Marquette, Michigan), fully remote, or hybrid with a remote work option up to three (3) days per week 
Works in office conditions, but occasional travel is required
Exposure to situations requiring exceptional interpersonal skills or high productivity
Occasionally subjected to irregular hours
Subject to many interruptions
 Remote Work Requirements:
Remote candidates must reside in the state of Michigan
For fully remote team members, initial on-site/in-person onboarding and training for a minimum of ten (10) consecutive business days at UPHP’s headquarters in Marquette, Michigan (stipend provided) 
Periodic travel to UPHP’s headquarters for regular training including all staff meetings
Private home office required; computer and phone hardware provided
Personal vehicle required for periodic travel; mileage reimbursement provided at GSA rate
Employment Type: FULL_TIME

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