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Remote Hcc Risk Adjustment Coder Jobs in Pennsylvania

Solventum

OP CDI Product Manager

Pittsburgh, PA · On-site +1

Strong knowledge of outpatient CDI, ICD-10-CM coding, HCC risk adjustment, quality risk ... Remote Travel: May include up to 10-% Relocation Assistance: Not authorized Must be legally ...

Urrly

Telehealth Nurse Practitioner

Harrisburg, PA · Remote

$600 - $720/day

Complete risk adjustment documentation (HCC coding) * Close HEDIS care gaps during patient visits ... Fully remote - no commute, no travel * Consistent visit flow and structured workflows Schedule ...

Clark Associates

Director of Risk

Lancaster, PA · On-site +1

... adjustments. * Oversee reserving practices, claim strategies, and root-cause assessments. Risk ... Remote Work Qualifications * Access to a reliable and secure high-speed internet connection. Cable ...

Victaulic

VDC Project Manager- Scheduling

Easton, PA · On-site +1

... remote. Ensure project pods are aligned with customer requirements, workflow priorities, and ... updates, risk mitigation strategies, and timeline adjustments as needed. Maintain dashboards ...

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

As of Jun 9, 2026, the average hourly pay for remote hcc risk adjustment coder in Pennsylvania is $20.38, according to ZipRecruiter salary data. Most workers in this role earn between $16.54 and $21.73 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
Certified Coding Specialist I (Risk Adjustment)

Certified Coding Specialist I (Risk Adjustment)

UPMC Health Plan

Pittsburgh, PA • Remote

Other

Posted 4 days ago

Job description

At UPMC Health Plan, we're looking for a detail-oriented Certified Coding Specialist I to join our Medicare HCC team. If you enjoy digging into medical records, applying your coding expertise, and making a meaningful impact on data accuracy and patient care-you'll feel right at home here.

This is a full-time, remote role working either 6:00 AM - 2:00 PM or 7:00 AM - 3:00 PM EST. If you're located in another time zone, you'll just need to be comfortable working these Eastern Time hours.

What You'll Do

In this role, you'll play a critical part in ensuring accurate coding and documentation across a variety of care settings. On a typical day, you'll:

  • Review inpatient, outpatient, physician, and emergency department records to assign accurate diagnosis and procedure codes
  • Apply your expertise in ICD-10-CM, CPT, and HCC risk adjustment coding to ensure proper classification of diagnoses
  • Analyze documentation such as discharge summaries, H&Ps, progress notes, consults, and operative reports
  • Identify and validate diagnoses submitted through claims by comparing them against clinical documentation
  • Audit coding for accuracy and completeness before submission-and make corrections when needed
  • Consistently meet quality (95% accuracy) and productivity standards
  • Track and maintain your daily coding productivity and time logs
  • Use coding tools, systems, and resources to work efficiently and accurately
How You'll Make an Impact

Your work will directly support accurate risk adjustment and data integrity across the health plan. You'll help ensure that diagnoses are properly captured, which ultimately supports better care planning, reporting, and outcomes.

What Helps You Succeed
  • Strong knowledge of medical terminology, anatomy, physiology, and pathology
  • Confidence working across multiple documentation types and care settings
  • A keen eye for detail and commitment to accuracy
  • The ability to manage your time independently in a remote environment
  • A proactive mindset-you're comfortable identifying issues and helping improve processes
What Else to Expect
  • Ongoing learning opportunities including coding education, seminars, and updated guidelines
  • A collaborative team environment where your input and ideas are valued
  • Monthly coding meetings to stay aligned and continuously improve
  • A structured, process-driven environment with clear expectations and support

If you're ready to bring your coding expertise to a team that values accuracy, collaboration, and continuous improvement-we'd love to hear from you.

  • Graduate of an AHIMA or AAPC Certified Coding Program that includes Anatomy & Physiology, Pharmacology and Medical Terminology.
  • 5 years of total experience required.
  • Five for more years or risk adjustment experience highly preferred.
  • Knowledge of Microsoft Office.
    Licensure, Certifications, and Clearances:
  • Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) required.
  • Act 34


UPMC is an Equal Opportunity Employer/Disability/Veteran

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