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Seasonal Hcc Risk Adjustment Coding Jobs in New York

Healthfirst (New York)

Hybrid Coding Educator

New York, NY · On-site

$29.75 - $34/hr

Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs Responsible for managing and responding to provider inquiries via the coding hotline as well. * Trains ...

Oscar Health

Senior Data Scientist

New York, NY · Hybrid

$163K - $215K/yr

The Risk Adjustment Data Science team turns that data into the models, pipelines, and systems that ... code review, and testing Bonus points: * Advanced degree in a quantitative or technical field

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Seasonal Hcc Risk Adjustment Coding information

What is a seasonal HCC risk adjustment coder?

A Seasonal HCC Risk Adjustment Coder is a healthcare professional who reviews medical records to identify and code diagnoses that impact risk adjustment scores, typically during peak periods such as the Medicare Advantage sweep season. HCC stands for Hierarchical Condition Category, a coding system used by Medicare to predict healthcare costs based on patient diagnoses. These coders ensure accurate documentation, which directly affects insurance reimbursement and compliance. Seasonal roles are common due to the cyclical nature of risk adjustment reporting deadlines.

What are the key skills and qualifications needed to thrive as a seasonal HCC risk adjustment coder?

To thrive as a Seasonal HCC Risk Adjustment Coder, you need a strong understanding of ICD-10-CM coding, risk adjustment methodologies, and a certification such as CPC, CRC, or CCS. Proficiency in coding software, electronic health records (EHRs), and risk adjustment platforms is typically required. Attention to detail, analytical thinking, and strong organizational skills help ensure accuracy and compliance in reviewing medical records. These skills are essential to accurately capture patient risk profiles, support healthcare reimbursement, and maintain regulatory compliance.

What are the most common challenges faced by professionals in seasonal HCC risk adjustment coding roles, and how can they be managed?

Seasonal HCC Risk Adjustment Coders often face the challenge of managing high volumes of medical records within tight deadlines, especially during peak audit or submission periods. Ensuring coding accuracy and compliance with evolving CMS guidelines can also be demanding, as even minor errors may impact reimbursement and risk scores. Staying organized, regularly participating in training updates, and leveraging coding software tools can help manage workloads and maintain accuracy. Collaborating closely with clinical teams and other coders is vital for clarifying documentation and sharing best practices.

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

AspectSeasonal Hcc Risk Adjustment CodingHcc Risk Adjustment Coding
CredentialsCertifications in coding and risk adjustmentCertifications in coding and risk adjustment
Work EnvironmentHealthcare facilities, insurance companies, remoteHealthcare facilities, insurance companies, remote
Industry UsageUsed seasonally for specific risk adjustmentsUsed year-round for ongoing risk management
Search IntentUnderstanding seasonal coding differencesGeneral risk adjustment coding practices

Seasonal Hcc Risk Adjustment Coding focuses on coding practices during specific times of the year, often related to seasonal health trends. In contrast, Hcc Risk Adjustment Coding involves continuous coding to manage patient risk profiles throughout the year. Both roles require similar certifications and work environments but differ mainly in their temporal focus and application.

What are popular job titles related to Seasonal Hcc Risk Adjustment Coding jobs in New York?

For Seasonal Hcc Risk Adjustment Coding jobs in New York, the most frequently searched job titles are:

What job categories do people searching Seasonal Hcc Risk Adjustment Coding jobs in New York look for?

The top searched job categories for Seasonal Hcc Risk Adjustment Coding jobs in New York are:

What cities in New York are hiring for Seasonal Hcc Risk Adjustment Coding jobs?

Cities in New York with the most Seasonal Hcc Risk Adjustment Coding job openings:

Seasonal Hcc Risk Adjustment Coding jobs near you
Infographic showing various Seasonal Hcc Risk Adjustment Coding job openings in New York as of August 2026, with employment types broken down into 1% As Needed, 91% Full Time, 6% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution.

Director of Coding Compliance

Essen Medical Associates

Bronx, NY • On-site

$85K - $110K/yr

Full-time

Re-posted 18 days ago

Essen Health Care rating

4.6

Company rating: 4.6 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Overview
Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state's most vulnerable and underserved residents.
Founded in 1999, we've grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women's health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.
We're looking for talented, motivated individuals to join our growing team. Whether you're a medical provider, administrator, or operations professional, there's a career here for you. Join us in making a real difference in the health of our community.
Job Summary
Position Title: Director of CodingCompliance
Position Summary: The Director of Coding Compliance is responsible for leading coding compliance and audit activities related to health plan operations, risk adjustment, payer audits and regulatory requirements. This role ensures accurate medical coding, documentation integrity, and adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess advanced CPC coding expertise, strong analytical skills, and extensive experience supporting compliance initiatives within a managed care or health plan environment.
Responsibilities
Key Responsibilities
  • Conduct complex coding audits and documentation reviews for accuracy, completeness, and regulatory compliance.
  • Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer guidelines.
  • Identify coding trends, compliance risks, and opportunities for operational improvement.
  • Partner with Compliance, SIU, Clinical Operations, Provider Education, and RCM teams to support organizational initiatives.
  • Develop and deliver provider and staff education related to coding accuracy and compliance standards.
  • Monitor regulatory changes and communicate impacts to leadership and operational teams.
  • Assist with internal and external audit preparation, corrective action plans, and regulatory responses.
  • Support oversight activities related to FWA (Fraud, Waste, and Abuse) prevention and documentation integrity.
  • Analyze audit findings and prepare detailed reports, dashboards, and executive summaries.
  • Serve as a subject matter expert for coding compliance and regulatory requirements.

Qualifications
Required Qualifications
  • Certified Professional Coder (CPC) certification required.
  • Minimum 7-10 years of medical coding and compliance auditing experience.
  • Minimum 5 years of experience within a health plan, managed care organization, or payer environment.
  • Strong knowledge of CMS regulations, Medicare Advantage, NYS Medicaid, HEDIS, and risk adjustment methodologies.
  • Extensive experience with ICD-10-CM, CPT, and HCPCS coding systems.
  • Knowledge of healthcare compliance standards and regulatory requirements.
  • Experience conducting coding audits and developing corrective action plans.
  • Strong analytical, communication, and leadership skills.
  • Proficiency with coding and audit software applications and Microsoft Office Suite.

Preferred Qualifications
  • CRC, CPMA, CCS, or other advanced coding/audit certification preferred.
  • Experience supporting delegated vendor oversight and regulatory audits.
  • Knowledge of NCQA standards and healthcare quality programs.
  • Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, or related field preferred.

Core Competencies
  • Regulatory Compliance
  • Risk Assessment
  • Medical Coding Expertise
  • Audit & Monitoring
  • Provider Education
  • Cross-Functional Collaboration
  • Strategic Problem Solving
  • Data Analysis & Reporting

Work Environment
  • Onsite - Bronx, New York Office Monday - Friday

Equal Opportunity Employer
Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population

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