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Senior Hcc Risk Adjustment Coder Jobs in Arizona

Phoenix Staff

Senior Data & AI Engineer

Phoenix, AZ · On-site +1

$50 - $60/hr

Senior Data & AI Engineer Location: Phoenix, AZ (hybrid remote) Type: 6-month contract to hire Pay ... Experience with Epic or Cerner integrations, HEDIS or risk adjustment programs, MLOps tools such as ...

PMA Companies

Senior Risk Control Consultant

Phoenix, AZ · On-site

$90K - $120K/yr

The Sr. Risk Control Consultant will apply risk control and risk management techniques in the ... Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of ...

AIG

Senior Underwriting Assistant

Scottsdale, AZ · On-site

This role assists the underwriters by screening risk offerings and with pre and post-binding ... Performs quality control of adjustments prior to underwriting review; documents discrepancies and ...

Achieve

Sr. Data Scientist (Credit Risk)

Tempe, AZ · On-site

We are looking for an experienced, hands-on Credit Risk, Sr. Data Scientist who is comfortable working with large data sets, coding in SQL and Python and gaining insights from the data and ...

Achieve

Sr. Data Scientist (Credit Risk)

Tempe, AZ · On-site +1

We are looking for an experienced, hands-on Credit Risk, Sr. Data Scientist who is comfortable working with large data sets, coding in SQL and Python and gaining insights from the data and ...

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Senior Hcc Risk Adjustment Coder information

What does a Senior HCC Risk Adjustment Coder do?

A Senior HCC Risk Adjustment Coder reviews medical records and assigns appropriate ICD-10 codes to ensure accurate risk adjustment for healthcare organizations. Their work supports proper reimbursement and compliance by identifying and coding Hierarchical Condition Categories (HCCs) based on clinical documentation. Senior coders typically have advanced knowledge of coding guidelines, risk adjustment models, and relevant regulations such as Medicare Advantage requirements. They may also audit coding work, provide training, and help implement best practices within their teams.

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

Senior HCC Risk Adjustment Coders often encounter challenges such as keeping up with frequent coding guideline updates, navigating complex electronic health record systems, and ensuring accurate documentation to support risk adjustment scores. To address these, staying current with industry training and certification requirements is essential, as is developing strong communication skills to collaborate effectively with providers and other coding professionals. Regular auditing and feedback can also help maintain high accuracy and compliance, contributing to both individual and team success.

What are the key skills and qualifications needed to thrive as a Senior HCC Risk Adjustment Coder, and why are they important?

To thrive as a Senior HCC Risk Adjustment Coder, you need in-depth knowledge of ICD-10-CM coding, risk adjustment methodologies, and a relevant credential such as CPC, CRC, or CCS. Familiarity with coding software, EHR systems, and risk adjustment analytics platforms is essential. Attention to detail, analytical thinking, and strong communication skills distinguish top performers in this role. These skills ensure accurate documentation and coding, directly impacting healthcare organizations' compliance and financial outcomes.
Senior Hcc Risk Adjustment Coder jobs near you
Senior Data & AI Engineer

Senior Data & AI Engineer

Phoenix Staff

Phoenix, AZ • On-site, Remote

$50 - $60/hr

Contractor

Posted 29 days ago

Key responsibilities

  • Design, implement, and optimize data platforms using Snowflake and Microsoft Fabric, including Lakehouses, Warehouses, OneLake, and engineering pipelines.

  • Build and deploy machine learning pipelines for risk modeling, utilization forecasting, fraud detection, quality measurement, and care gap analysis.

  • Collaborate with clinicians, actuaries, product teams, and analysts to translate business needs into scalable technical solutions.

Job description

Title: Senior Data & AI Engineer

Location: Phoenix, AZ (hybrid remote)

Type: 6-month contract to hire

Pay: $50-60/hr

We’re looking for a Senior Data & AI Engineer to lead the design and delivery of secure, scalable data and AI solutions within complex healthcare environments. The position focuses on building modern data platforms, integrating diverse clinical and claims datasets, and operationalizing machine learning models that improve cost, quality, and patient outcomes.

Your role

·       Design, implement, and optimize data platforms using Snowflake and Microsoft Fabric, including Lakehouses, Warehouses, OneLake, and engineering pipelines.

·       Build and maintain scalable ingestion frameworks for batch and streaming data sources such as APIs, ADLS, SFTP, and event streams with full lineage and governance.

·       Develop secure data environments that comply with HIPAA and PHI requirements using role-based access, masking, tokenization, and de-identification.

·       Create conceptual, logical, and physical data models using dimensional, normalized, and data vault approaches.

·       Transform and normalize structured and unstructured healthcare data including claims, eligibility, enrollment, provider, and clinical documentation.

·       Integrate and harmonize data using FHIR, HL7, X12/EDI 837/835, NCPDP, and CMS standards across payer, provider, EHR, and HIE systems.

·       Build and deploy machine learning pipelines for risk modeling, utilization forecasting, fraud detection, quality measurement, and care gap analysis.

·       Operationalize models with strong MLOps practices including versioning, CI/CD, monitoring, and drift detection.

·       Implement data cataloging, metadata management, lineage tracking, and quality validation using tools such as Microsoft Purview or equivalent.

·       Monitor and optimize pipeline performance, cost, and reliability across Snowflake and Fabric environments.

·       Collaborate with clinicians, actuaries, product teams, and analysts to translate business needs into scalable technical solutions.

·       Document architecture, data mappings, and design standards while mentoring engineers and contributing to enterprise best practices.

What you’ve got

·       8+ years of experience in data engineering or analytics with at least 5 years of hands-on Snowflake expertise including virtual warehouses, tasks, streams, Snowpipe, RBAC, masking, and data sharing.

·       2+ years of experience with Microsoft Fabric including OneLake, Lakehouses, Warehouses, Dataflows Gen2, Notebooks, and Pipelines.

·       Advanced SQL skills with strong experience in ETL/ELT development using Python, dbt, Dataflows, or Fabric/ADF pipelines.

·       Deep knowledge of healthcare data standards including CMS datasets, FHIR, HL7, X12/EDI, provider data, eligibility, and claims processing.

·       Strong data modeling experience including dimensional modeling, SCD types, surrogate keys, 3NF, and data vault methodologies.

·       Experience building and deploying machine learning solutions using tools such as scikit-learn, PyTorch, TensorFlow, Azure ML, or Fabric ML.

·       Practical experience managing HIPAA compliance, PHI handling, auditing, and secure access controls within cloud data environments.

·       Experience working with both structured data formats such as Parquet and CSV and unstructured data such as clinical notes and PDFs.

·       Strong communication skills with the ability to produce mapping specifications, lineage documentation, and present technical trade-offs clearly.

·       Preferred: Experience with Epic or Cerner integrations, HEDIS or risk adjustment programs, MLOps tools such as MLflow or GitHub Actions, Power BI semantic modeling, and relevant Snowflake or Microsoft certifications.

To find more great tech-centric jobs, please visit www.phoenixstaff.com.