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Senior Hcc Risk Adjustment Coder Jobs in Santa Clara, CA

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

Expert knowledge of Medicare HCC risk adjustment models. * Working knowledge of CPT, HCPCS, and ICD-9/10 medical coding. * Familiarity with data analytical tools like SQL and visualization platforms ...

Astiva Health

Quality Improvement Coordinator

San Jose, CA · On-site

$23 - $25/hr

The Quality Improvement Coordinator will be responsible for coordinating and implementing quality improvement initiatives related to HEDIS measures and risk adjustments/HCC. This individual will work ...

Astiva Health

Quality Improvement Coordinator

San Jose, CA · Hybrid

$23 - $26/hr

The Quality Improvement Coordinator will be responsible for coordinating and implementing quality improvement initiatives related to HEDIS measures and risk adjustments/HCC. This individual will work ...

Hippocratic AI Inc.

Senior Actuary

Palo Alto, CA · On-site

$170 - $250/hr

About the Role Hippocratic AI is looking for a Senior Actuary to join our G&A team, reporting to ... or risk adjustment (e.g., HCC models). * Advanced proficiency in SQL, Python, R, or actuarial ...

Hippocratic AI

Senior Actuary

Menlo Park, CA · On-site

About the Role Hippocratic AI is looking for a Senior Actuary to join our G&A team, reporting to ... or risk adjustment (e.g., HCC models). * Advanced proficiency in SQL, Python, R, or actuarial ...

Mudflapinc

Senior Data Scientist, Risk

Palo Alto, CA · On-site

$185 - $225/hr

Senior Data Scientist, Risk Location: Palo Alto, CA Employment Type: Full time Location Type ... leadership, code reviews, and strategic guidance while developing scalable data science ...

Mudflap

Senior Data Scientist, Risk

Palo Alto, CA · On-site

$220K - $245K/yr

As a Senior Data Scientist, Risk , you will develop the models, insights, and strategies that help ... leadership, code reviews, and strategic guidance while developing scalable data science ...

Mudflap

Senior Data Scientist, Risk

Palo Alto, CA · On-site

$185 - $225/hr

We're looking for a versatile Senior Data Scientist, Risk to join our high-impact team. In this ... leadership, code reviews, and strategic guidance while developing scalable data science ...

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Senior Hcc Risk Adjustment Coder information

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

As of Sep 5, 2026, the average hourly pay for senior hcc risk adjustment coder in Santa Clara, CA is $34.40, according to ZipRecruiter salary data. Most workers in this role earn between $25.67 and $34.18 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 the key skills and qualifications needed to thrive as a Senior HCC Risk Adjustment Coder?

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.

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 most commonly searched types of Hcc Risk Adjustment Coder jobs in Santa Clara, CA?

The most popular types of Hcc Risk Adjustment Coder jobs in Santa Clara, CA are:

What cities near Santa Clara, CA are hiring for Senior Hcc Risk Adjustment Coder jobs?

Cities near Santa Clara, CA with the most Senior Hcc Risk Adjustment Coder job openings:

Senior Hcc Risk Adjustment Coder jobs near you

Risk Adjustment Director

Medix

Scotts Valley, CA • On-site

$96.15 - $120.19/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 11 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a skilled Risk Adjustment Director to serve as the executive strategic leader and subject matter expert for the health plan's Risk Adjustment Department. The primary responsibilities include designing and overseeing data strategies to ensure accurate member health coding, managing financial impacts of risk scores, leading a team, and acting on behalf of the CFO when necessary.
Responsibilities / Job Duties
  • Build the roadmap for the health plan's risk adjustment goals to improve data collection, reporting, and auditing.
  • Track risk scores and work closely with Actuaries and Financial Planning & Analysis to align with budgets.
  • Optimize Risk Adjustment Factor improvements through external vendors.
  • Partner with the Provider Relations Director to train and support doctors on compliant, accurate medical record coding.
  • Hire, train, mentor, and evaluate a team of risk adjustment professionals.
  • Formulate and manage the Risk Adjustment Department's operational budget.
  • Oversee Medicare DSNP Risk Adjustment strategy and execution.
  • Directly support key operational initiatives to ensure program stability and scalability.

Minimum Education and Experience Qualification Requirements
Education
  • Bachelor's degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field.

Qualifications
  • 10 years of experience in healthcare finance or analytics.
  • 5 years of experience with Medicare risk adjustment processes.
  • 2 years of experience related to Medicare Managed Care Programs.
  • 3 years of supervisory experience.
  • Expert knowledge of Medicare HCC risk adjustment models.
  • Working knowledge of CPT, HCPCS, and ICD-9/10 medical coding.
  • Familiarity with data analytical tools like SQL and visualization platforms like Tableau.

Skills
  • Technical proficiency in data analytical tools and coding methodologies.
  • Strong leadership and team management skills.
  • Excellent communication and organizational abilities.

Schedule / Shift
Mon-Fri 8am-5pm (potential for some flexibility for early/later start upon discussion)
Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

Required Employment / Compliance Language
Medix is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients
Medix Staffing Solutions logo

About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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