Medicare HCC Coding Analyst, CRC Certification

Alignment Health

. Interface with provider partners to monitor and implement HCC coding strategies .

Posted 10/8/2026full-timeRemote • United StatesMid-LevelSenior💰 $58,531 - $87,797 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in HCC coding strategies, risk adjustment processes, and compliance with federal and state regulations. Proficient in developing educational materials and conducting audits to ensure data accuracy and quality in healthcare settings.

Highest-signal resume keywords

HCC Coding ExperienceRisk Adjustment ManagementCertified CoderExperience with Athena EHRStatistical Analysis

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Professional CodingData ValidationCoding AuditsICD-9/ICD-10 KnowledgeMathematical Calculations

Soft Skills

Effective CommunicationLeadershipProblem-SolvingOrganizational SkillsTime Management

Tools & Technologies

MS Office SuiteMS AccessEpicAllscriptsEZCap

Certifications & Qualifications

Certified CoderCCSCCS-PCPCCertified Auditor

Industry Keywords

Risk AdjustmentHCC CodingCMS ComplianceHealthcare AuditingProvider Education

About the role

Key responsibilities & impact

Interface with provider partners to monitor and implement HCC coding strategies
Audit all RAPS submissions for accuracy of data provided to CMS
Conduct or coordinate ongoing coding and abstracting quality audits
Develop, implement, evaluate, and improve IPA educational tools for providers to accurately capture acute and chronic conditions
Track and report coding vendor audit progress to ensure coding accuracy and data quality submitted to CMS
Work with Risk Adjustment Management on Data Validation and RADV coding audits
Maintain tracking and management tools for assigned IPAs within the provider network
Track Risk Adjustment activities for assigned medical groups and ensure timely completion
Correlate activities, processes, and HCC results/metrics to evaluate outcomes
Ensure compliance with applicable federal, state, and local regulations and organizational policies
Support scheduling and training activities and maintain training records
Suggest physician group Risk Adjustment coding initiatives and participate in SCITs/education meetings
Coordinate Risk Adjustment audit activities for assigned groups and assist with CMS Data Validation activities
Update Risk Adjustment materials for clinical and official guideline changes
Update education materials based on CMS-HCC Model and ICD-9/ICD-10 annual changes
Enhance clinical educational materials for physicians and clinical staff on Risk Adjustment programs, clinician chart reviews, and encounter documentation
Customize Risk Adjustment education for different audiences
Stay current on industry coding, compliance, and HCC issues
Maintain professional and technical knowledge through workshops, publications, networks, and professional societies
Perform related duties as needed

Requirements

What you’ll need

Minimum 3+ years of coding in a medical group or health plan setting
Professional Coding experience
Minimum 1 year experience with strategic planning in risk mitigation
High School Diploma or GED
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 constructive relationships with diverse members, management, employees and vendors
Ability to perform mathematical calculations and calculate simple statistics correctly
Ability to prioritize multiple tasks and use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolutions
Effective problem-solving, organizational and time management skills; ability to work in a fast-paced environment
Ability to comprehend and analyze statistical reports
Certified Coder required
HCC/Risk Adjustment experience
Experience with Athena EHR
Work Pacific Standard Time
Previous experience with Epic, Allscripts, or EZCap preferred
Certified Coder training courses preferred
Proficiency in MS Office Suite preferred; MS Access a plus
CCS, CCS-P, CPC, or Certified Auditor preferred