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Senior Hcc Risk Adjustment Coder Jobs in Decatur, GA

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Urrly

Telehealth Nurse Practitioner

Atlanta, GA · Remote

$600 - $720/day

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

Urrly

Telehealth Nurse Practitioner (Remote)

Atlanta, GA · Remote

$600 - $720/hr

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

Emory Inc.

CDCE Data Analyst

Atlanta, GA

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

Emory Healthcare

CDCE Data Analyst

Atlanta, GA · On-site

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

Emory Healthcare

CDCE Data Analyst

Atlanta, GA

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

Tmhcc

Senior Catastrophe Risk Modeler

Kennesaw, GA · Hybrid

Tokio Marine HCC is a leading specialty insurance company with a global footprint supporting the ... As a Catastrophe Risk Modeler, you will utilize your technical expertise in catastrophe risk ...

Emory Healthcare

CDCE Data Analyst

Atlanta, GA

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

Emory Healthcare

CDCE Data Analyst

Atlanta, GA · On-site

$52.37 - $65.06/hr

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

Tmhcc

Senior Catastrophe Risk Modeler

Alpharetta, GA · Hybrid

Tokio Marine HCC is a leading specialty insurance company with a global footprint supporting the ... As a Catastrophe Risk Modeler, you will utilize your technical expertise in catastrophe risk ...

Enlace Health

Senior Medical Economics Analyst

Atlanta, GA · On-site

$84K - $112K/yr

Evaluating acuity, case-mix, and coding impacts across populations * Write advanced SQL queries to ... CMS revenue and risk adjustment data * Value-based performance datasets * Strong proficiency in SQL ...

Enlace Health

Senior Medical Economics Analyst

Atlanta, GA · On-site

$84K - $112K/yr

Evaluating acuity, case-mix, and coding impacts across populations * Write advanced SQL queries to ... CMS revenue and risk adjustment data * Value-based performance datasets * Strong proficiency in SQL ...

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Senior Hcc Risk Adjustment Coder information

See Decatur, GA salary details

$16

$28

$69

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

As of Jul 22, 2026, the average hourly pay for senior hcc risk adjustment coder in Decatur, GA is $28.60, according to ZipRecruiter salary data. Most workers in this role earn between $21.35 and $28.41 per hour, depending on experience, location, and employer.

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
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Atlanta, GA • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

238th of 281 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • Certified professional coder (CPC)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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