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Remote Hcc Risk Adjustment Coder Jobs in Michigan

This role is remote. The Risk, Quality, and Performance Analyst serves as the Risk, Quality, and ... Maximus TCS (Technology and Consulting Services) Internal Job Profile Code: TCS015, P3, Band 6 Job ...

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

$62K - $94K/yr

Monitors and evaluates underwriting practices, assisting with implementing strategic adjustments to ... Remote Job Requirements Education: Bachelor's Degree in Business, Economics, Risk Management and ...

$62K - $94K/yr

Monitors and evaluates underwriting practices, assisting with implementing strategic adjustments to ... Remote Job Requirements Education: Bachelor's Degree in Business, Economics, Risk Management and ...

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Remote Hcc Risk Adjustment Coder information

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.
What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Michigan? The most popular types of Hcc Risk Adjustment Coder jobs in Michigan are:
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Risk, Quality and Performance Analyst

Risk, Quality and Performance Analyst

Maximus

Flint, MI • Remote

Full-time

Medical, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


Maximus rating

6.9

Company rating: 6.9 out of 10

Based on 292 frontline employees who took The Breakroom Quiz

243rd of 437 rated business services


Job description

Description & Requirements

Maximus is a trusted federal partner supporting mission‑critical programs across national security, defense, and public service delivery. Our work focuses on sustaining, operating, and improving essential government systems and services, with proven operational excellence, and a commitment to mission success for our customers.

Joining Maximus means becoming part of a collaborative, mission‑driven organization where teamwork, accountability, and professional growth are core to how we operate. We invest in our workforce through training, education, and career development, empowering professionals to deliver high‑impact solutions while contributing to outcomes that matter at a national scale.

This position is contingent upon contract award and position availability. Selected candidates will receive a contingent offer of employment, which will become final only upon successful contract award to Maximus, availability of the position, and receipt of authorization to proceed.

Ability to obtain and maintain a Public Trust is required. An active Public Trust and/or DHS suitability is preferred. Must be a U.S. Citizen without dual citizenship. This role is remote.

The Risk, Quality, and Performance Analyst serves as the Risk, Quality, and Performance Analyst supporting an enterprise IT services contract. This role is responsible for monitoring and reporting on service quality, performance metrics, and risk management activities to ensure compliance with contract requirements and federal standards. The analyst supports continuous improvement initiatives, validates deliverables and operational processes, and contributes to performance reviews, SLA tracking, and governance reporting. The position also provides backup support for onboarding and administrative compliance functions as required by the contract.

Maximus TCS (Technology and Consulting Services) Internal Job Profile Code: TCS015, P3, Band 6

Job-Specific Essential Duties and Responsibilities:

- Serve as the Risk, Quality, and Performance Analyst, ensuring compliance with service quality, performance metrics, and governance requirements.

- Develop, monitor, and report on performance metrics, KPIs, and SLAs, supporting continuous service improvement and operational transparency.

- Conduct quality assurance reviews of operational processes, deliverables, and reporting artifacts to ensure alignment with agency standards and federal best practices.

- Support risk identification, tracking, and mitigation activities, including operational risks, compliance risks, and performance risks across functional areas.

- Assist with audit readiness, process documentation, and quality controls, ensuring artifacts meet agency and federal oversight expectations.

- Coordinate with program management, operations, and cybersecurity teams to support service reviews, performance reporting, and corrective action plans.

- Provide support for onboarding, administrative, and compliance functions, including documentation tracking, training verification, and access readiness as required.

Job-Specific Minimum Requirements:

- Ability to obtain and maintain a Public Trust is required. An active Public Trust and/or DHS suitability is preferred. Must be a U.S. Citizen without dual citizenship.

- Bachelor’s degree in Business, Information Systems, Computer Science, Engineering, or a related field.

- 5+ years of experience in quality assurance, performance management, risk management, or IT service management in a federal or enterprise IT environment.

- Demonstrated experience performing quality assurance, performance analysis, or risk management functions in a federal or enterprise IT environment, including validation of deliverables, processes, and reporting artifacts.

- Proven ability to develop, monitor, and report Key Performance Indicators (KPIs), Service Level Agreements (SLAs), and performance metrics in support of continuous service improvement.

- Experience supporting risk identification, tracking, mitigation, and reporting, including maintenance of risk registers and corrective action plans.

- Knowledge of IT Service Management (ITSM) concepts and operational governance, including quality controls, performance reviews, and compliance monitoring.

- Ability to review, assess, and validate documentation for accuracy, completeness, and compliance with federal standards, policies, and contract requirements.

- Experience producing clear, accurate written reports and briefings for program management and government stakeholders.

- Familiarity with federal information security and compliance environments, sufficient to support quality and performance oversight activities.

Preferred Skills and Qualifications:

- Knowledge of IT Service Management (ITSM), SLA monitoring, and performance reporting frameworks.

- Familiarity with ServiceNow, SharePoint, or similar enterprise reporting and workflow tools.

- Experience supporting risk registers, quality management plans, and continuous improvement initiatives.

- Strong written and verbal communication skills for executive‑level reporting and stakeholder coordination.

#techjobs #clearance #veteransPage #LI-remote

Minimum Requirements

TCS015, P3, Band 6

#TSTECH

EEO Statement

Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Accommodations

Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com .


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