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Remote Hcc Risk Adjustment Coding Jobs in Pennsylvania

Advocate Aurora Health

$38.20 - $57.30/hr

Remote work is currently only approved for residents living in the following states: AL, AK, AR, AZ ... coding guidelines and Medicare Risk Adjustment Payment Methodology related to HCC/RAFs

New

Solventum

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 ...

Humana

Records Retrieval Specialist

Mechanicsburg, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Harrisburg, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Lancaster, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

York, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

York, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Harrisburg, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Mechanicsburg, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Lancaster, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Carlisle, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Mechanicsburg, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Harrisburg, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Carlisle, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Carlisle, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

Lancaster, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

Humana

Records Retrieval Specialist

York, PA · Remote

$40K - $52K/yr

This is a remote role with field-based responsibility, requiring travel to provider offices to ... As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect ...

New

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All JobsHcc Risk Adjustment Coding JobsRemote Hcc Risk Adjustment Coding JobsRemote Hcc Risk Adjustment Coding Jobs in Pennsylvania

Remote Hcc Risk Adjustment Coding information

See Pennsylvania salary details

$17

$21

$23

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

As of Jul 13, 2026, the average hourly pay for remote hcc risk adjustment coding in Pennsylvania is $21.55, according to ZipRecruiter salary data. Most workers in this role earn between $18.08 and $22.88 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 Pennsylvania? The most popular types of Hcc Risk Adjustment Coding jobs in Pennsylvania are:
What are popular job titles related to Remote Hcc Risk Adjustment Coding jobs in Pennsylvania? For Remote Hcc Risk Adjustment Coding jobs in Pennsylvania, the most frequently searched job titles are:
What job categories do people searching Remote Hcc Risk Adjustment Coding jobs in Pennsylvania look for? The top searched job categories for Remote Hcc Risk Adjustment Coding jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Remote Hcc Risk Adjustment Coding jobs? Cities in Pennsylvania 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 Pennsylvania as of July 2026, with employment types broken down into 1% As Needed, 72% Full Time, 18% Part Time, 1% Temporary, 7% Contract, and 1% Nights. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution, with an average salary of $44,831 per year, or $21.6 per hour.
Condition Management & Documentation Consultant - Remote

Condition Management & Documentation Consultant - Remote

Advocate Aurora Health

On-site, Remote

$38.20 - $57.30/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

New

Advocate Aurora Health rating

7.6

Company rating: 7.6 out of 10

Based on 771 frontline employees who took The Breakroom Quiz

191st of 882 rated healthcare providers

Job description

Department:
13576 Value Enablement Services - Value Based: CMD
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
40
Schedule Details/Additional Information:
Remote work is currently only approved for residents living in the following states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.
Monday - Friday hours between 7am - 5pm, no weekends, no holidays. Remote work responsibilities in supporting clinicians in the IL division. Occasional travel may be required.
Pay Range:
$38.20 - $57.30
Major Responsibilities:
  • Develops, coordinates and implements the strategic direction of the CMD program as it relates to the education for Advocate Aurora Health and Advocate Physician Partners. This includes providing education, consultation and direction to the providers and all levels of the organization as it relates to managing clinical risk.
  • Develops, standardizes, maintains and implements risk adjustment training programs, materials, websites and workflows for all areas of the organization to achieve CMD program goals.
  • Serves as the subject matter expert and internal primary point of contact for all Condition Management and Documentation related topics and guidance by maintaining an expert level of knowledge of Medicare and risk-based reimbursement methodology including CMS & IMO updates affecting HCCs, ICD 10 coding practices, Medicare/HHS risk adjustment models, Hierarchical Condition Categories (HCCs) and Risk Adjustment Factors (RAFs), clinical/charge capture functionality, internal processes and maintains professional and technical knowledge through webinars, workshops, professional publications and personal networking.
  • Works with coding/coding auditors to develop work ques/rules to identify CMD related focus areas for querying and missed codes and coordinate manual chart reviews of a practice to analyze clinical documentation to identify patterns and trends to develop appropriate Performance Improvement plans.
  • Participates with coding and compliance in risk-adjustment chart reviews including RAD-V/RACCR audits to identify patterns and trends and shares findings as appropriate.
  • Participates in EHR updates related to Risk Adjustment IMO/best practice alerts (BPA's)/suspect condition and grouper updates from CMS and has knowledge of clinic workflows and Epic workflows to be able to troubleshoot for informatics, test new EHR CMD related programming and put forth possible solutions.
  • Develops and maintains effective internal relationships through effective and timely communication.
  • Data mines & synthesizes raw data and organizes key performance indicators, presents information, and provides summary of material. Provides analysis and reporting on progress and results including the overall RAF score, improvement strategies and tactics.
  • Collaborates with quality, operations and providers to develop recommendations to complete PDSA/Improvement plans to drive Risk Adjustment improvement that includes creating tools and reports to meet CMD goals.
  • Collaborates with other stakeholders such as: IT, Population Health, Quality Improvement, Advocate Physician Partners Compliance, IP CDI, Coding and Informatics, other members of the CMD Team, Primary Care and Specialty Service Lines to develop new EHR tools, optimize existing functionality, identify clinical documentation and coding opportunities and develop system processes that work with the designated EHR.

Licensure, Registration, and/or Certification Required:
  • Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
  • Registered Nurse license issued by the state in which the team member practices, or
  • Certified Risk Adjustment Coder (CRC) issued by American Academy of Professional Coders (AAPC). needs to be obtained within 1 year.

Education Required:
  • Bachelor's Degree in Health Information Management, or
  • Bachelor's Degree in Nursing or related field.

Experience Required:
  • Typically requires 5 years of experience in healthcare (payer, population health, quality, coding, managing health care clinical risk or similar industry)

Knowledge, Skills & Abilities Required:
  • Ability to lead programs interacting with all levels of the organization
  • Medicare Advantage knowledge strong preference
  • Strong knowledge of ICD diagnoses coding guidelines and Medicare Risk Adjustment Payment Methodology related to HCC/RAFs
  • Professional experience influencing changes in behavior.
  • Knowledge of payor plan requirements and impact to RAF scores as it relates to MSSP and Medicare Advantage programs
  • Knowledge of EPIC and reporting solutions
  • Ability to operate in a fast-paced, dynamic environment
  • Detail oriented; possess strong initiative, problem solving skills and ability to set/manage multiple priorities to meet deadlines in an expedient and decisive manner with minimal supervision
  • Intermediate proficiency in Word, PowerPoint, Excel, Outlook including ability to create pivot tables, formatting, sorting, create sheets with formulas (sum, vlookup)
  • Strong verbal/written communication skills; ability to present in front of a group; ability to translate coding/EHR issues in plain language to providers via tip sheets, case studies, in person/emails
  • Excellent organizational capabilities to execute projects/program and work effectively as a team player
  • Strong aptitude for critical thinking and demonstrated analytical and data skills. Willingness to acquire new knowledge from an unfamiliar domain

Physical Requirements and Working Conditions:
  • Must be able to drive to various sites throughout the Advocate Aurora Health footprint so therefore will be exposed to weather and road conditions.
  • Ability to work from home or in office setting.
  • Operates all equipment necessary to perform the job.
  • Exposed to normal office environment.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
  • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
  • Premium pay such as shift, on call, and more based on a teammate's job
  • Incentive pay for select positions
  • Opportunity for annual increases based on performance

Benefits and more
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

What Advocate Aurora Health employees say

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Hours and flexibility

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About Advocate Health

Sourced by ZipRecruiter

Advocate Healthcare, based in Oak Lawn, Illinois, United States, is a leading figure in the health care industry. Accessible via their official website, 'advocatehealth.com', this organization provides a wide variety of medical services and treatment options. Founded in 1995 through a merger of Evangelical Health Systems Corporation and Lutheran General HealthSystem, Advocate Healthcare has grown exponentially over the years. Now, it operates more than 400 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers, and three Level II trauma centers. Upholding their values of equality, compassion, excellence, partnership and stewardship, Advocate Healthcare's mission is centered on building lifelong relationships with patients by delivering the best health outcomes and highest level of service through an integrated approach to care and wellness.

Industry

Hospitals and health care and social assistance

Company size

10,000+ Employees

Headquarters location

Charlotte, NC, US

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