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Remote Hcc Risk Adjustment Coder Jobs in Azusa, CA

Current medical coding certification such as Certified Professional Coder (CPC), Certified Coding ... Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value ...

Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ... Code with ICD-10 and CPT II * Deliver care plans and follow-up * Keep clean, audit-ready ...

Manager - Advanced Analytics

Alhambra, CA ยท Remote

$160K - $170K/yr

... risk adjustment, quality analytics (HEDIS) utilization management, finance, and claims. * Experience working with healthcare datasets and measures such as HCC, HEDIS, and clinical analytics.

Manager - Advanced Analytics

Alhambra, CA ยท Remote

$160K - $170K/yr

... risk adjustment, quality analytics (HEDIS) utilization management, finance, and claims. * Experience working with healthcare datasets and measures such as HCC, HEDIS, and clinical analytics.

Remote work may be permitted within a commutable distance from the worksite. REQUIREMENTS: Master ... Qualified applicants please apply online at and utilize reference code #72772. Please indicate ...

Remote work may be permitted within a commutable distance from the worksite. REQUIREMENTS: Master ... Qualified applicants please apply online at and utilize reference code #72772. Please indicate ...

Medicare business consists of understanding CMS bids, rebates, HCC, RAF scores, risk types, revenue ... ARC codes, payment methodologies, and various plan codes. * Submit month end data loads to ...

Be Seen First

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and ... Ensures claim files are properly documented and claims coding is correct. * Refers cases as ...

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Remote Hcc Risk Adjustment Coder information

See Azusa, CA salary details

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

As of Jun 8, 2026, the average hourly pay for remote hcc risk adjustment coder in Azusa, CA is $22.81, according to ZipRecruiter salary data. Most workers in this role earn between $18.37 and $24.47 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.
What are the most commonly searched types of Hcc Risk Adjustment Coder jobs in Azusa, CA? The most popular types of Hcc Risk Adjustment Coder jobs in Azusa, CA are:
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What cities near Azusa, CA are hiring for Remote Hcc Risk Adjustment Coder jobs? Cities near Azusa, CA with the most Remote Hcc Risk Adjustment Coder job openings:

Risk Adjustment Coding Specialist II - Remote

Astrana Health, Inc.

Monterey Park, CA โ€ข On-site, Remote

$70K - $85K/yr

Full-time

Posted 4 days ago


Job description

Risk Adjustment Coding Specialist II - Remote
Department: Quality - Risk Adjustment
Employment Type: Full Time
Location: 1600 Corporate Center Dr., Monterey Park, CA 91754
Reporting To: Didi Lawter
Compensation: $70,000 - $85,000 / year
Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our IPAs across the nation. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You'll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you'll track and report on key performance metrics-such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience!
Our Values:
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned

Qualifications
  • Must be open to traveling to provider sites within Connecticut and possibly surrounding areas. Reliable transportation and valid Driver's License required
  • Certified Professional Coder (CPC) AND Certified Risk Adjustment Coder (CRC) certifications from AAPC
  • 3-5+ years of experience in risk adjustment coding and billing experience
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding softwares and Electronic Health Records (EHR) systems.
  • Strong knowledge with PowerPoint, preparing presentations, and public speaking
  • Strong experience with Excel - reports, pivot tables, VLOOKUP, etc.

You're great for this role if:
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through AAPC highly preferred
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Experience with multiple EMR/EHR systems
  • Experience with Monday.com and PowerBI
  • Ability to work independently and collaborate in a team setting
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role will be fully remote and likely work in CST hours, however, some work across time zones may be necessary.
  • This is a full-time position, M-F 830-5.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.comto request an accommodation.