Support the development and validation of predictive models for HCC suspecting, risk score ... Mentors others on coding standards and performs code reviews * Supervises others on developing ...
Support the development and validation of predictive models for HCC suspecting, risk score ... Mentors others on coding standards and performs code reviews * Supervises others on developing ...
Support the development and validation of predictive models for HCC suspecting, risk score ... Mentors others on coding standards and performs code reviews * Supervises others on developing ...
Support the development and validation of predictive models for HCC suspecting, risk score ... Mentors others on coding standards and performs code reviews * Supervises others on developing ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
... coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required * Subject matter expertise on the CMS HCC Risk Adjustment ...
Serves as a subject matter expert on coding. * Leads and consults with operations on ad hoc requests/special projects. * Works collaboratively with Enterprise Risk Adjustment team, Business ...
Serves as a subject matter expert on coding. * Leads and consults with operations on ad hoc requests/special projects. * Works collaboratively with Enterprise Risk Adjustment team, Business ...
Serves as a subject matter expert on coding. * Leads and consults with operations on ad hoc requests/special projects. * Works collaboratively with Enterprise Risk Adjustment team, Business ...
Serves as a subject matter expert on coding. * Leads and consults with operations on ad hoc requests/special projects. * Works collaboratively with Enterprise Risk Adjustment team, Business ...
Serves as a subject matter expert on coding. * Leads and consults with operations on ad hoc requests/special projects. * Works collaboratively with Enterprise Risk Adjustment team, Business ...
Serves as a subject matter expert on coding. * Leads and consults with operations on ad hoc requests/special projects. * Works collaboratively with Enterprise Risk Adjustment team, Business ...
Outpatient Clinical Documentation Improvement Specialist
Saint Marys, OH · Remote
$33 - $44.50/hr
Understand documentation requirements for HCC and risk adjustment coding * Support accurate reporting for quality initiatives and value-based care * Identify documentation gaps that affect population ...
Quick apply
Outpatient Clinical Documentation Improvement Specialist
Saint Marys, OH · Remote
$33 - $44.50/hr
Understand documentation requirements for HCC and risk adjustment coding * Support accurate reporting for quality initiatives and value-based care * Identify documentation gaps that affect population ...
Outpatient Clinical Documentation Improvement Specialist
Saint Marys, OH · On-site
$33 - $44.50/hr
Understand documentation requirements for HCC and risk adjustment coding * Support accurate reporting for quality initiatives and value-based care * Identify documentation gaps that affect population ...
Outpatient Clinical Documentation Improvement Specialist
Saint Marys, OH · On-site
$33 - $44.50/hr
Understand documentation requirements for HCC and risk adjustment coding * Support accurate reporting for quality initiatives and value-based care * Identify documentation gaps that affect population ...
Experience with Medicare Advantage and risk adjustment programs, including HCC coding. * Experience auditing physician, outpatient, and/or hospital medical records. * Experience interpreting and ...
Experience with Medicare Advantage and risk adjustment programs, including HCC coding. * Experience auditing physician, outpatient, and/or hospital medical records. * Experience interpreting and ...
Medical Record Training Consultant
Mason, OH · On-site +1
Experience with Medicare Advantage and risk adjustment programs, including HCC coding. * Experience auditing physician, outpatient, and/or hospital medical records. * Experience interpreting and ...
Medical Record Training Consultant
Mason, OH · On-site +1
Experience with Medicare Advantage and risk adjustment programs, including HCC coding. * Experience auditing physician, outpatient, and/or hospital medical records. * Experience interpreting and ...
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Medical Coder CPC / CCS
$18 - $24.25/hr
... with Risk Adjustment. Provide overall coding expertise as well as administrative and technical ... Monitor HCC Coding Accuracy at various levels of detail (e.g., by state, by product, by demographic ...
Medical Coder CPC / CCS
$18 - $24.25/hr
... with Risk Adjustment. Provide overall coding expertise as well as administrative and technical ... Monitor HCC Coding Accuracy at various levels of detail (e.g., by state, by product, by demographic ...
HIM Coder - Professional
Portsmouth, OH · On-site
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
HIM Coder - Professional
Portsmouth, OH · On-site
Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.
Experience with risk adjustment, HCC coding, and clinical documentation standards (DSP/MEAT criteria)-candidates without this background will receive structured training. * Multi-setting background ...
Experience with risk adjustment, HCC coding, and clinical documentation standards (DSP/MEAT criteria)-candidates without this background will receive structured training. * Multi-setting background ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Director of Revenue Cycle Management
Cincinnati, OH · On-site +1
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Director of Revenue Cycle Management
Cincinnati, OH · On-site +1
Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff. * Manage relationships and accountability with third-party billing vendors ...
Lead IP Coding Quality Analyst
Columbus, OH · On-site +1
Lead IP Coding Quality Analyst Department: Health System Shared Services | MIM CDI and Coding ... The role plays a critical part in supporting denial prevention, risk adjustment accuracy, and ...
Lead IP Coding Quality Analyst
Columbus, OH · On-site +1
Lead IP Coding Quality Analyst Department: Health System Shared Services | MIM CDI and Coding ... The role plays a critical part in supporting denial prevention, risk adjustment accuracy, and ...
Billing Specialist
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Familiarity with value-based care models, risk adjustment, and clinical documentation standards (HCC capture, MEAT/DSP criteria) preferred. * Behavioral health and substance use disorder experience ...
Familiarity with value-based care models, risk adjustment, and clinical documentation standards (HCC capture, MEAT/DSP criteria) preferred. * Behavioral health and substance use disorder experience ...
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Billing Specialist
Columbus, OH · On-site
$19 - $26/hr
The Medical Billing Specialist ensures accurate coding, timely claim submission, and efficient ... Knowledge of risk adjustment (HCC), HEDIS-quality documentation, and prior auth workflows.
Trainee Hcc Risk Adjustment Coding information
Can I get a job as a medical coder with no experience?
Is HCC coding a good career?
What are some common challenges faced by Trainee HCC Risk Adjustment Coders, and how can they be overcome?
What is the difference between Trainee Hcc Risk Adjustment Coding vs Hcc Risk Adjustment Coder?
| Aspect | Trainee Hcc Risk Adjustment Coding | Hcc Risk Adjustment Coder |
|---|---|---|
| Certifications | None or entry-level certifications | Certified Professional Coder (CPC) or equivalent |
| Work Environment | Training programs, supervised settings | Independent coding in healthcare facilities |
| Job Responsibilities | Learning coding processes, assisting with documentation | Accurate coding, claim submission, compliance |
The main difference is that Trainee Hcc Risk Adjustment Coders are in training or entry-level roles, focusing on learning and assisting, while Hcc Risk Adjustment Coders are experienced professionals responsible for independent coding and compliance tasks.
What is a Trainee HCC Risk Adjustment Coder?
What are the key skills and qualifications needed to thrive as a Trainee HCC Risk Adjustment Coder, and why are they important?
How to become a risk adjustment coder?
How much do HCC coders make in the US?

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 11 days ago
Elevance Health rating
7.8
Based on 334 frontline employees who took The Breakroom Quiz
165th of 261 rated insurance
Job description
Anticipated End Date:
2026-06-19Position Title:
Senior Risk Adjustment AnalystJob Description:
Location: Norfolk VA, Mason OH, Indianapolis IN, Louisville KY, Grand Prairie TX, Tampa FL, Atlanta GA
Hours: Standard Working hours
Travel: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Position Overview:
The Senior Risk Adjustment Analyst is a high-impact individual contributor on Elevance's Medicare Advantage Risk Adjustment team, reporting directly to the Staff VP of Analytics/Decision Support. This role is responsible for conducting advanced data analysis, building and maintaining HCC performance reporting, supporting predictive modeling initiatives and monitoring vendor performance. The Sr. Analyst serves as a key analytical resource, translating complex data into actionable insights for both clinical and operational stakeholders.
How You Will Make an Impact:
Design, develop, and maintain risk adjustment performance dashboards and reports using Power BI, Tableau, or equivalent tools to monitor KPIs
Write and optimize complex SQL queries to extract, transform, and analyze large datasets from data warehouses and payer/provider data systems
Support the development and validation of predictive models for HCC suspecting, risk score forecasting, and provider performance stratification
Prepare and present analytical findings, trend analyses, and performance summaries to key internal stakeholders
Mentor junior analysts and coordinators, providing guidance on analytical methods, data interpretation, and risk adjustment concepts
Support cross-functional initiatives in quality, population health, provider engagement and finance as they relate to risk adjustment analytics
Maintains active relationships with customers to determine business requirements, leads requirement meetings
Proactively addresses customer issues, prepares alternatives and implements solutions
Collaborates with engineers for creative ideas for supporting interactive content, analyzes and classifies complex change request and reviews and evaluates possible enhancements
Identifies and manages risks and develops contingency plans
Partners with business, architecture and infrastructure and oversees all service levels
Develops and defines application scope and objectives, including impact to interfaces
Analyzes and evaluates detailed business and technical requirements
Mentors others on coding standards and performs code reviews
Supervises others on developing application internals for usability, reliability and scalability requirements
Ensures system testing is completed and meets the test plan requirements
Coordinates integration activities with other IT to ensure successful implementation and support of project efforts
Assesses current status and supports BI planning efforts
Mentors and assists in training initiatives and performs estimates for costs and impacts
Manages small to medium projects, potentially leading global projects
Mentors and provides training, conducts vendor evaluations and manages pilots for Business Intelligence tool upgrades
Required Qualifications:
Requires an BA/BS degree in Information Technology, Computer Science or related field of study and minimum of 5 years experience with multi platform, two or more BI applications and/or multiple Business Intelligence tools required; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Medicare Advantage or commercial Risk adjustment data analysis experience is a must have
SQL experience strongly preferred
Intermediate Excel experience preferred
Power BI experience is nice to have
Job Level:
Non-Management ExemptWorkshift:
1st Shift (United States of America)Job Family:
IFT > Engineering/DevPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.
What Elevance Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Elevance Health
Sourced by ZipRecruiter
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Indianapolis, IN, US
Year founded
2004