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Work From Home Hcc Risk Adjustment Coding Jobs (NOW HIRING)

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · Remote

$30 - $35/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · Remote

$22.50 - $31/hr

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group ...

All About People

Be Seen First

Quality Assurance Coder & Auditor - HCC Coding

OR · Remote

$48.49/hr

Review and validate HCC coding and risk adjustment documentation . * Identify missed, unsupported ... Ability to work independently and effectively in a remote environment. Preferred Experience

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group ...

Bannerhealth

Risk Adjustment Coding Reviewer

Risk Adjustment Work Shift: Day Job Category: Risk, Quality and Safety A rewarding career that fits ... The posted compensation range is a reasonable estimate that extends from the lowest to the highest ...

Altegra Health

Remote Certified Coders

Memphis, TN · Remote

$21.75 - $29.75/hr

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group ...

Virtix Health LLC

HCC Coding Quality Specialist

All HCC/Risk Adjustment auditors MUST be certified through either the AAPC or AHIMA ... Remote Work from home (within the U.S. ONLY). You need a HIPAA compliant home office, high-speed ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: • Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · On-site +1

$22.50 - $31/hr

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: • Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC ...

Altegra Health

Remote Certified Coders

Memphis, TN · On-site +1

$21.75 - $29.75/hr

... Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: • Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC ...

Urrly

Telehealth Nurse Practitioner

Des Moines, IA · On-site +1

$600 - $720/day

Join a fast-growing virtual care team and work from home in Iowa while earning $600-$720 per day ... Document HCC risk adjustment during patient visits * Close HEDIS (quality measures) care gaps

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Work From Home Hcc Risk Adjustment Coding information

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How much do work from home hcc risk adjustment coding jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for work from home hcc risk adjustment coding in the United States is $27.49, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $34.62 per hour, depending on experience, location, and employer.

What is work from home HCC risk adjustment coding?

Work from home HCC (Hierarchical Condition Category) risk adjustment coding involves reviewing medical records and assigning appropriate diagnosis codes to reflect the health status of patients for insurance and Medicare purposes. Coders ensure that all relevant conditions are accurately documented to support proper reimbursement and compliance with regulations. Working remotely allows coders to complete these tasks from home, often using secure online systems provided by their employer. This role requires a solid understanding of medical terminology, coding systems like ICD-10-CM, and risk adjustment models.

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

To thrive as a Work From Home HCC Risk Adjustment Coder, you need a strong understanding of ICD-10-CM coding, knowledge of Hierarchical Condition Categories (HCC), and typically a certification such as CPC or CRC. Familiarity with electronic medical record (EMR) systems and coding software is essential for accurate and efficient code assignment. Attention to detail, self-motivation, and strong communication skills help ensure compliance and productivity in a remote environment. These skills are crucial to ensure accurate risk adjustment coding, which impacts healthcare reimbursement and quality reporting.

What are some common challenges faced by work from home HCC risk adjustment coders, and how can they be managed?

Work From Home HCC Risk Adjustment Coders often face challenges such as maintaining consistent productivity, managing complex medical records, and staying current with evolving coding guidelines. Without in-person supervision, it can be difficult to stay focused and avoid distractions, so setting up a dedicated workspace and sticking to a structured schedule is essential. Additionally, regular communication with team members and participating in ongoing training can help coders stay updated and collaborate effectively. Leveraging secure technology for remote access and adhering strictly to HIPAA regulations is also crucial to ensure data privacy and compliance.

What is the difference between Work From Home Hcc Risk Adjustment Coding vs Work From Home Medical Coding Specialist?

AspectWork From Home Hcc Risk Adjustment CodingWork From Home Medical Coding Specialist
CertificationsAHIMA or AAPC HCC certifications, coding credentialsCPH, CPC, or equivalent medical coding certifications
Work EnvironmentRemote, healthcare insurance industryRemote, healthcare or hospital settings
Industry UsageHealth insurance, risk adjustment programsHospitals, clinics, insurance companies
Job FocusRisk adjustment, HCC coding for Medicare/MedicaidGeneral medical coding, billing, and documentation

Work From Home Hcc Risk Adjustment Coding specialists focus on coding for risk adjustment models, primarily in insurance and Medicare programs, requiring specific HCC certifications. In contrast, Work From Home Medical Coding Specialists handle broader medical coding tasks across various healthcare settings. Both roles are remote and require coding credentials, but their industry focus and job responsibilities differ.

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Risk Adjustment Coding Specialist

Greater Good Health

Remote

$80K - $95K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 29 days ago

Job description

Job Title: Risk Adjustment Coding Specialist
Job Location: Remote
Company Description
Greater Good Health is a fast-growing organization delivering care to older adults in access starved communities. Our innovative model is led by Nurse Practitioners and focused on outcomes, not volume—meaning we prioritize quality over quantity, spend more time with our patients, and are accountable for their health and well-being.
Whether through our own senior-focused primary care clinics or our suite of integrated clinical solutions for health plans and provider groups, we are making value-based care more accessible and more effective. We help reduce avoidable healthcare costs, improve clinical outcomes, and create a best-in-class patient experience.
If you're passionate about transforming healthcare and delivering meaningful care to those who need it most, Greater Good Health offers a purpose-driven, collaborative, and supportive environment where your work can make a lasting impact.
The Role
We are looking for a Risk Adjustment Coding Specialist to own retrospective CDI chart review and strengthen coding compliance, documentation accuracy, and risk adjustment optimization across our Medicare-focused primary care model. The ideal candidate brings deep expertise in Medicare risk adjustment, a strong understanding of outpatient clinical documentation, and the ability to translate complex coding requirements into practical guidance for clinical and revenue teams.
This role will work closely with leaders across Revenue Cycle, Clinical Operations amp; Clinical Performance to drive compliant, accurate, and optimized coding — resolving documentation and coding queries, closing retrospective review backlogs against CMS filing deadlines, and identifying opportunities to improve risk capture while reducing audit risk. The ability to communicate clearly with both clinical and non-clinical stakeholders is essential.
This role will ensure coding accuracy and consistency by helping design and formalize coding audit processes, documentation standards, and education materials. You will review charts, support query resolution, and provide insights into coding trends and regulatory changes that impact our operations.
The right person for this role will apply their extensive knowledge of Medicare risk adjustment coding to real-world clinical workflows, balancing compliance, operational efficiency, and scalability. This role offers meaningful autonomy, a focused but impactful scope, and the opportunity to directly strengthen our coding and compliance foundation as we continue to grow.
Responsibilities
  • Own retrospective CDI chart review for compliant, accurate and optimized coding
  • Design and execute formal coding audits to ensure CPT and diagnosis coding are compliant and fully supported by clinical documentation
  • Identify documentation gaps, education opportunities, and compliance concerns; support escalation and remediation efforts as needed
  • Partner with Revenue Cycle to support claim corrections, rebilling, and documentation follow-up
  • Assist with coding research for new or evolving CPTs and services, including documentation and billing requirements and Medicare reimbursement considerations
  • Support resolution of coding and documentation queries, collaborating with providers to amend documentation where appropriate
  • Develop coding and documentation education content for Nurse Practitioners and clinical teams, informed by audit findings and recurring themes
  • Build and maintain CDI worklists and audit trackers in Excel, including formula-driven flags for missed HCCs, recapture opportunities, and documentation gaps
  • Translate chart audit findings into structured Excel-based reporting (trend summaries, provider-level scorecards) for Revenue Cycle and Clinical Operations leadership
  • Support Care Services leadership with open condition management and risk adjustment workflows, including coaching and training as needed
  • Monitor and report on changes in the coding and risk adjustment landscape, including new, revised, or retired codes and regulatory guidance
  • Help formalize coding-related processes and documentation suitable for internal policies and compliance reference
Qualifications
Credentials amp; Certifications
  • Certified Risk Adjustment Coder (CRC or equivalent) required
  • CDI credential preferred (CDIP, CCDS, or equivalent) in addition to CRC
Clinical amp; Coding Experience
  • Medicare risk adjustment experience required
  • Demonstrated Clinical Documentation Improvement (CDI) experience, including query construction, provider education, and documentation gap remediation
  • Strong knowledge of ICD-10-CM coding guidelines, HCC models, and Medicare documentation requirements
  • Experience in outpatient clinic and/or primary care settings
  • Value-Based Care (VBC) experience
  • Experience supporting or participating in coding audits or compliance reviews preferred
Technical Skills
  • Proficiency in Excel, including pivot tables, VLOOKUP/XLOOKUP, conditional formatting, and data validation, for chart audit tracking and trend reporting
  • Experience building or maintaining audit worklists/trackers in Excel
Communication amp; Collaboration
  • Strong communication skills with the ability to translate coding guidance for clinical, operational, and finance stakeholders
  • Comfortable training and coaching providers on documentation and coding best practices, including delivering feedback on individual query patterns
What Will Make You Successful at GGH
  • If you “bring it” every day and are continually hungry to learn, share, and tackle challenges.
  • You thrive in an environment that champions learning, growth, agency, and autonomy. We support each team member to work at the “top of their license” and find fulfillment in their work.
  • We can trust that your words and actions align. We own our mistakes and share our learning with others. We think and act with consideration for people, time, rules, resources, ethics, and GGH’s success.
Perks and Benefits:
  • Competitive Compensation Package: We offer a competitive compensation package to recognize your valuable contributions and ensure your financial security.
  • Comprehensive Medical, Dental, and Vision Benefits: Take advantage of comprehensive healthcare coverage, including medical, dental, and vision benefits, to prioritize your health and well-being.Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) available.
  • Paid Time Off: Enjoy paid holidays, vacation time, and paid parental leave to maintain a healthy work-life balance and spend quality time with your loved ones.
  • 401K Program with Company Match: Plan for your future with our 401K program, featuring a company match, to help you save for retirement.
  • Monthly Phone/Internet Reimbursement: Stay connected with our monthly phone and internet reimbursement, ensuring you have the tools you need to excel in your role.
  • Comprehensive Life and AD amp;D Coverage: Enjoy peace of mind with 100% premiums covered by GGH for Basic Life and Accidental Death amp; Dismemberment (AD amp;D) insurance for full-time team members. Additionally, voluntary supplemental life insurance is offered at a discounted rate.
  • Short-Term Disability Coverage: Gain additional financial security with voluntary short-term disability (STD) coverage. This benefit provides a percentage of your salary during periods of illness or injury that prevent you from working for a set period of time.
  • Collaborative and Supportive Community: Join our collaborative and supportive GGH Nurse Practitioner Community, with dedicated care coordinators and MD advisors, to foster professional growth and success

Don’t check off every box in the requirements listed above? Please apply anyway! Studies have shown that marginalized communities - such as women, LGBTQ+ and people of color - are less likely to apply to jobs unless they meet every single qualification. GGH is dedicated to building an inclusive, diverse, equitable, and accessible workplace that fosters a sense of belonging – so if you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, we encourage you to still consider applying. You may be just the right candidate for this role or another one of our openings!

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