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Remote Hcc Risk Adjustment Coding Jobs in Ohio (NOW HIRING)

Tmhcc

Senior Underwriter - Artisan E&S

Westerville, OH · On-site +1

$94K - $112K/yr

Remote Location: Ohio (Will consider candidates in other states) Tokio Marine HCC, a global power ... Evaluate new and renewal policy applications and related documents to classify and assess each risk ...

CareSource

Applied AI Scientist III

Dayton, OH · On-site +1

... expertise and code reviews. Essential Functions: * Evaluate emerging technology in LLMs, NLP ... Work closely with interdisciplinary teams across IT, risk adjustment, program integrity, HEDIS ...

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Remote Hcc Risk Adjustment Coding information

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$16

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$22

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

As of Jul 11, 2026, the average hourly pay for remote hcc risk adjustment coding in Ohio is $20.44, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $21.73 per hour, depending on experience, location, and employer.

What is the difference between Remote Hcc Risk Adjustment Coding vs Remote Hcc Risk Adjustment Coding?

AspectRemote Hcc Risk Adjustment Coding

Since the comparison is with itself, the roles are identical. Both involve coding for HCC risk adjustment, require similar credentials like coding certifications, and are performed remotely within healthcare insurance environments. The primary difference lies in specific employer requirements or specialization, but generally, these roles are the same in scope and industry usage.

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

Remote HCC Risk Adjustment Coders often encounter challenges such as interpreting complex medical records without direct access to providers for clarification, staying updated on frequent coding guideline changes, and managing productivity expectations in a home-based environment. To address these, coders benefit from strong communication skills to clarify documentation through digital channels, participating in ongoing education and training, and utilizing coding software or company-provided resources efficiently. Employers typically support coders with regular team meetings, access to compliance specialists, and robust knowledge-sharing platforms to help overcome these hurdles.

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 in-depth knowledge of ICD-10-CM coding guidelines, HCC risk adjustment models, and a coding certification such as CPC, CRC, or CCS. Familiarity with electronic health record (EHR) systems, coding software, and secure remote work platforms is essential. Attention to detail, analytical thinking, and strong organizational skills help coders ensure accuracy and compliance. These skills are vital for precise diagnosis coding, optimizing risk scores, and supporting reimbursement and quality initiatives in healthcare organizations.

What is remote HCC risk adjustment coding?

Remote HCC risk adjustment coding involves reviewing patient medical records from a remote location to identify and assign Hierarchical Condition Category (HCC) codes. These codes help determine the risk score of patients, which affects healthcare reimbursements for organizations. HCC coders must have a strong understanding of medical terminology, coding guidelines, and compliance regulations. They typically work from home, using secure software to ensure patient data privacy and accuracy in coding.
What are the most commonly searched types of Hcc Risk Adjustment Coding jobs in Ohio? The most popular types of Hcc Risk Adjustment Coding jobs in Ohio are:
What are popular job titles related to Remote Hcc Risk Adjustment Coding jobs in Ohio? For Remote Hcc Risk Adjustment Coding jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Hcc Risk Adjustment Coding jobs in Ohio look for? The top searched job categories for Remote Hcc Risk Adjustment Coding jobs in Ohio are:
What cities in Ohio are hiring for Remote Hcc Risk Adjustment Coding jobs? Cities in Ohio with the most Remote Hcc Risk Adjustment Coding job openings:
Remote Hcc Risk Adjustment Coding jobs near you
Infographic showing various Remote Hcc Risk Adjustment Coding job openings in Ohio as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $42,519 per year, or $20.4 per hour.
Quality Risk Adjustment Advisor IV (Health Plan experience required)

Quality Risk Adjustment Advisor IV (Health Plan experience required)

CareSource

Dayton, OH • On-site, Remote

$83K - $132K/yr

Full-time

Posted 16 days ago

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

182nd of 281 rated insurance

Job description

Job Summary:
The Quality Risk Adjustment Advisor IV is responsible for leading key components of the Quality Risk Adjustment (QRA) programs, including prospective programs, chart retrieval and coding processes, while ensuring compliance with regulatory standards and optimizing quality outcomes. This role partners closely with internal stakeholders and external vendors to enhance operational effectiveness and leverage artificial intelligence (AI) technologies to improve data accuracy, efficiency, and overall program performance.
Essential Functions:
  • Serve as a subject matter expert in Risk Adjustment operations, supporting prospective programs, chart retrieval and coding processes.
  • Identify and recommend strategies to optimize risk adjustment processes and improve quality metrics across insourced and outsourced activities, including leveraging AI for process enhancement.
  • Partner with vendors to support execution of operational production plans and contractual requirements.
  • Monitor vendor performance and identify opportunities to improve efficiency, quality, and cost management.
  • Collaborate with QRA Compliance to support development and maintenance of quality assurance protocols.
  • Conduct audits and assessments to ensure accuracy, completeness, and efficiency.
  • Research and evaluate technological solutions, including AI/NLP tools.
  • Partner with Data Science, IT, and Sourcing teams to support deployment of AI solutions.
  • Collaborate with cross-functional teams to support operational goals.
  • Identify and implement process improvements.
  • Monitor and analyze key performance indicators (KPIs).
  • Gather and translate business requirements into actionable recommendations.
  • Assess build vs. buy AI solutions.
  • Support evaluation and monitoring of AI solution performance.
  • Provide guidance and informal coaching to stakeholders as needed.
  • Perform any other job related duties as requested.

Education and Experience:
  • Bachelor's degree in Health Administration, Healthcare Management, or a related field required
  • Master's degree is preferred
  • Equivalent years of relevant work experience may be accepted in lieu of required education
  • Seven (7) years experience in risk adjustment, medical record review, coding, or quality management required
  • Two (2) years experience with AI solutions in a healthcare setting required
  • Leadership experience preferred
Competencies, Knowledge and Skills:
  • Knowledge of ICD-10 Coding
  • Knowledge of HCC Risk Adjustment models
  • Knowledge of CMS regulatory guidelines
  • Strong analytical and problem-solving skills
  • Ability to apply AI technologies in healthcare
  • Strong communication and collaboration skills
  • Ability to influence stakeholders without direct authority
Licensure and Certification:
  • None
Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time
  • Travel is not typically required

Compensation Range:
$83,000.00 - $132,800.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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