Remote Medicare HCC Coding Analyst | CRC Certification
$58.53k - $87.8kAlignment Health
Brooklyn, NY
- Remote job
- # Remote Medicare HCC Coding Analyst | CRC CertificationApply: Fully Remote: Anywhere in the U.S.: Full time: Posted Today: End Date: October 23, 2026 (14 days left to apply): R2618Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor and implement HCC coding strategies. Audit all RAPS submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide coding expertise as well as administrative oversight to ensure successful integration of AHC's HCC initiatives.**GENERAL DUTIES/RESPONSIBILITIES** 1. Monitors coding & abstracting quality by conducting &/or coordinating ongoing audits to ensure coding quality & performance improvement standards are maintained, achieved & improved. 2. Develops, implements, evaluates & improves IPA’s educational tools for their respective providers in order to accurately capture acute and chronic conditions. 3. Tracks & reports progress of the audits performed on the coding vendors in order to assure the coding accuracy and quality of the data submitted to CMS. 4. Works with Risk Adjustment Management on any Data Validation and /or RADV coding audit to ensure completeness and coding accuracy of all submissions to CMS. 5. Maintains a comprehensive tracking and management tool for assigned IPA’s within Alignments Healthcare provider network. 6. Tracks all Risk Adjustment activities for assigned medical groups and ensure that all tasks are completed in a timely manner. Correlate activities, processes, and HCC results/ metrics to evaluate outcomes. 7. Ensures compliance with all applicable federal, state &local regulations, as well as with institutional/organizational standards, practices, policies & procedures. 8. Supports the Risk Adjustment Management Team in scheduling/training activities. Maintain records of training. 9. Suggests new Physician Group Risk Adjustment coding initiatives. Participate in SCITs/ Education meetings as needed 10. Coordinates Risk Adjustment audit activities as it relates to the assigned groups. Assist with CMS Data Validation activities, including suggested record selections, tracking and submission, in conjunction with Risk Adjustment Healthcare Management 11. Educates and updates: a. Regularly updates all Risk Adjustment materials for clinical and official guideline changes. b. Updates all education materials based on CMS-HCC Model and ICD-9/ ICD-10 annual changes c. Suggests, updates, and enhances clinical educational materials to assist in training physicians and clinical staff on Risk Adjustment Healthcare Programs including CMS-HCC Models, Clinician Chart Reviews, and Encounter Documentation. d. Suggests customizations of Risk Adjustment education for various audiences, Support Staff, PCPs, Specialists, Employees vs. contracted and Central Departments e. Stays current of industry coding, compliance, and HCC issues. f. Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies. 12. Contributes to team effort by accomplishing related results as needed. 13. Other duties as assigned to meet the organization’s needs.**Job Requirements:****Experience:**• Required: Minimum 3+ years of coding in a medical group or health plan setting required; Professional Coding experience required. Minimum 1 year experience with strategic planning in risk mitigation.•Work Hours: Pacific Standard Time• Preferred: Previous experience and use of Epic, Allscripts, EZCap a plus **Education:**• Required: High School Diploma or GED.**Training:**• Preferred: Certified Coder training courses **Specialized Skills:**• Required:* Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.* Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;* Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly* Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.* Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.* Report Analysis Skills: Comprehend and analyze statistical reports.• Preferred: Proficient user in MS office suite, MS access a plus **Licensure:**• Required: Certified Coder required, HCC/Risk Adjustment experience, Experience with Athena EHR• Preferred: CCS, CCS-P, CPC, Certified Auditor a plus. **Work Environment:**The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.2 The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.Pay Range: $58,531.00 - $87,797.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.*\\*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email View email address on click.appcast.io.*
- J-18808-Ljbffr Alignment Health
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote Medicare HCC Coding Analyst | CRC Certification in Brooklyn, NY vacancy
$58.53k - $87.8k
...saving them. Together.The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to... ...submissions to ensure accuracy in the data provided to Centers for Medicare and Medicaid Services (CMS). Provide coding expertise as...Remote workFull timeLocal area- ...seeking a Risk Adjustment Clinical Documentation Specialist to advance documentation accuracy in a fully remote capacity. The role focuses on supporting coding accuracy, HCC capture, regulatory compliance, and clinical documentation integrity in outpatient settings. You...Remote job
$70k - $85k
...motivated Risk Adjustment Coding Specialist to... ...metricssuch as HCC recapture rates AWVs... ...verify that all Medicare Advantage Affordable... ...Required Certification/Licensure: Must possess... ...certification CPC. Additional CRC certification... ...This position is remotely based in the U.S....Remote workFull timeLive inWork at officeHome officeAstrana Health
Arizona2 days ago$35 per hour
...Title: Risk Adjustment Coding Oversight Specialist (Risk Analyst)Job Description This... ...for highly regulated Medicare Advantage risk... ...credential. Current CRC (Certified Risk Coder) certification. Minimum of 2+ years... ...you will collaborate remotely with team members based...Remote workContract workTemporary workShift workEarly shift- ...is seeking experienced HCC Risk Adjustment Medical... ...Coders for a high-volume, remote seasonal project supporting Medicare initiatives. Coders will review and code records with a target... ...adjustment coding, and certifications such as CCS, CPC, or CRC. Benefits include...Remote workHourly paySeasonal work
Insight Global
Plano, TX9 hours ago $62.7k - $97.2k
...medical record review and coding, and member and... ...record documentation, and HCC Coding. Conduct, collect... ...experience. Licenses or Certifications Required: Current State... ...Compact (eNLC), OR CPC, CRC, RHIA, RHIT, or CCS... ...Conditions Position Type: Remote. Teaches / trains others...Remote workFor contractorsWork at officeLocal area- ...Epic Healthy Planet Analyst (HCC Risk Adjustment) – Contract... ...) Location: Remote Employment Type: Contract... ...configuration , HCC coding workflows, risk... ...closure programs, and Medicare Advantage risk adjustment... ...~ Epic Healthy Planet Certification required. ~ Minimum...Remote workContract work
Medasource
Utah2 days ago - ...Payment Integrity Drg Coding & Clinical Validation Analyst The Payment Integrity DRG Coding & Clinical... ...and coding terminology. Coding Certification is to be maintained as a condition... ...Please note: The opportunity for remote work may be possible for all jobs posted...Remote workWork experience placement
- 3+ month Contract Remote Manager prefers not to... ...Epic Healthy Planet Certified Analyst Must have Healthy Planet certifications Must have Build and HCC experience If you have a... ...have experience with HCC coding framework. Must Haves...Remote workContract workImmediate start
3B Staffing LLC
Boston, MA20 hours ago $37 per hour
...Jersey.Short DescriptionThe Senior Chargemaster Analyst position requires a healthcare clinical or coding certification, college degree, with significant healthcare experience... ...investigative results.Understands coding/ HCC and billing requirements to ensure compliance...Remote workFull timePart timeWork experience placementCooper University Health Care
Camden, NJ2 days ago$22.78 - $29.62 per hour
Location Remote - Florida US:FL:Fort Myers Department Department... ...following applicable billing, coding and reimbursement regulations... ...edits as appropriate, reviews Medicare intermediary and other third... ...RequiredCertifications/Registration Requirements Certificates/RegistrationsRequired/...Remote workFull timeShift work- ...Seeking multiple full-time Remote HCC Coders (Coder 1), who will conduct accurate and compliant diagnosis code abstraction for Medicare, Commercial, and Medicaid risk adjustment programs... ...standing through AAPC or AHIMA (e.g., CRC, CPC, CCS) 1-2 years of experience in...Remote workFull time
Virtual Vocations Inc
United States5 days ago $27.5 - $44 per hour
...Clinical Reimbursement Analyst - RN - Long Term Care... ...Responsible to review Medicare/Medicaid documentation... ...reports for accuracy of MDS coding, benchmarks, gaps and... ...state. Additional certification from the American... ...Details Facility: Remote WI Location: Remote...Remote workFull timePart timeLive inShift workDay shiftGood Samaritan
Wisconsin9 hours ago£72k - £130k per year
...motivated, self-driven, technical analysts dedicated to making a... ...malware analysis. Perform remote remediation of malware or malicious... .../Scripting: experience coding in Powershell, C, C#, VB, Python... ...least one relevant security certification ~ Strong verbal and communication...Remote workPermanent employmentWork at officeLocal areaRemote6 days ago$143.62k - $229.79k
...with ACA Risk Adjustment, including HHS-HCC model methodology, risk score forecasting... ...Strong understanding of diagnosis coding (ICD-10-CM), provider documentation practices... ..., specialized skill sets, licensure and certifications and other business and organizational needs...Remote workBlue Cross and Blue Shield of North Carolina
United States1 day ago$33.88 - $42.35 per hour
...ICD-10 diagnoses based coding information as it pertains... ...Condition Categories (HCC). Participates in and supports the Medicare Risk Adjustment team-based... ...advanced knowledge, certifications, and experience related... ...Coding Specialist (CCS) or (CRC) Certified Risk Adjustment...Contract workWork experience placementFlexible hours- ...experienced Revenue Integrity Service Line Analysts, the fully remote position will manage revenue... ...clinical, operational, finance, and coding teams to enhance accurate revenue capture... ...integrity, coding, or revenue cycle certification preferred (CPC, COC, CCS, CHRI, CRCR,...Remote work
Virtual Vocations Inc
United States1 day ago $72k - $95k
...Clinical Informatics Analyst We are seeking a Clinical Informatics... ...available on a fully remote basis within the US. This... ...resolution of documentation and coding discrepancies. Support Epic... ...Cerner proficiency; active module certification (Ambulatory, Inpatient,...Remote workHourly payFull timeWork at officeWork from homeMonday to FridayTalentLNX
United States3 days ago- ...revenue cycle metrics, the full-time hybrid Charge Capture Analyst will manage analytics, maintain Chargemaster files,... ...4 years of experience in Accounting/Finance with a focus on coding, or 2 years in billing EPIC Certification in Area of Responsibility preferred...Remote workFull time
Virtual Vocations Inc
United States4 days ago - ...Opportunity: As an Appeals Analyst, you’ll review... ...CPT-4, HCPCS, Revenue Codes, DRG, and ICD-10 coding... ...~ Knowledgeable of Medicare reimbursement methodologies... ...related field. CPC Certification Experience with... ...Work: This is a fully remote position, and we’ll provide...Remote workContract workImmediate startFlexible hours
$89.29k - $131.85k
...Days)Overview:Overview The IT Specialty Analyst - Epic HIM Coding is responsible for the day-to-day... ...requirementsCertification/LicensureActive Epic HIM Coding Certification (Required)ExperienceMinimum of 3... ....For positions that are available as remote work, Sentara Health employs...Remote workFull timeTemporary workShift workSentara Healthcare
Virginia Beach, VA3 days ago- ...degree in Computer Science and Certifications in Sigma/Tableau software5 +... ...preferred)Strong SQL coding of at least 5 years.Strong data... ..., data modelers and business analysts to ensure the BI functional infrastructure... ...Thursday); Monday and Friday remote.Why join us?We don’t just “...Remote workHourly payFull timeWork at officeMonday to Friday
United Rentals
Bridgeport, CT6 days ago $81.04k - $145k
...organization, apply now.We are currently seeking a Medicaid Certification Analyst to join our team in Springfield, Illinois (US-IL), United States... ...for specific roles. The starting pay range for this remote role is $81,040 - $145,000. This range reflects the minimum...Remote workTemporary workWork experience placementWork at officeFlexible hoursNTT DATA
Springfield, IL5 days ago$42.41 - $63.62 per hour
...clinical documentation coding and charging,... ...compliance with policies. The analyst assists clinical areas... ...Education Diploma (GED)CERTIFICATION & LICENSURE:CPC-... ...and codingKnowledge of Medicare APC and OPPS reimbursement... ...SummaryLocation: Sacramento; Remote - Louisiana; Remote -...Remote workFull timeWork at officeLocal areaShift workSutter Health
Little Rock, AR5 days ago$92.7k - $148.4k
...at MSK: Sr. Revenue Integrity Analyst - Provider Education At... ...initiatives that strengthen coding accuracy and revenue performance... ...methodologies. Professional certification such as CPC, CCS, COC, RHIT,... ...Friday Location: Hybrid; Primary remote with on site as needed at 633...Remote workFull timeMonday to FridayMemorial Sloan-Kettering
New York, NY4 days ago$72.8k - $130k
...responsible for providing oversight to Optum360 coding services, directly overseeing facility-... ....You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you... ...markets, education, work experience, certifications, etc. In addition to your salary, we...Remote workMinimum wageFull timeWork experience placementLocal areaUnitedHealth Group
Houston, TX3 days ago- ...of business for Reveleer customers across Medicare Advantage (MA), Medicare Advantage... ...that quantify risk adjustment performance, HCC (Hierarchical Condition Category) capture... ...exposure and prioritizing chart review and coding efforts based on financial impact. Communicate...Remote workContract workLocal area
Reveleer
United States5 days ago $143.62k - $229.79k
...Remote Flex - North Carolina Remote Flex - Mississippi Remote... ...Adjustment , including HHS-HCC model methodology, risk score... ...understanding of diagnosis coding (ICD-10-CM) , provider documentation... ...skill sets, licensure and certifications and other business and...Remote workFull timeWork at officeLocal areaFlexible hours2 days per weekBlueCross BlueShield of North Carolina
United States1 day ago$50 per hour
...national accounting firm, is seeking a Remote Records and Information Analyst (RIM) for a yearlong remote... ...Recognized RIM/information governance certifications preferred, including at least one... ...preferred Python and SQL coding knowledge and experience is a plus...Remote workTemporary workWork from homeBeacon Hill
New York, NY9 days ago- ...description master experience *Charge audits *Coding & billing guidelines Schedule:... ...through Thursday onsite, and Friday remote. Upon successful training, hybrid 2... ...Finance, Healthcare preferred Training / Certification / Licensure: EPIC Revenue Integrity,...Remote workFull timeLocal areaMonday to FridayMonday to Thursday
VIRTUA
Mount Laurel, NJ2 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Medicare HCC Coding Analyst | CRC Certification. Be the first to apply!
Related searches
- senior program analyst Brooklyn, NY
- defense analyst Brooklyn, NY
- informatics analyst Brooklyn, NY
- pay analyst Brooklyn, NY
- administrative analyst Brooklyn, NY
- senior database analyst Brooklyn, NY
- design analyst Brooklyn, NY
- client success analyst Brooklyn, NY
- entry analyst Brooklyn, NY
- meditech analyst Brooklyn, NY