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Adjustment Analyst Jobs (NOW HIRING)

Centrum Health

Risk Adjustment Analyst

Doral, FL

The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare ...

Centrum Health

Risk Adjustment Analyst

Doral, FL · On-site

The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare ...

Cliff Services Inc

Data Risk Analyst

Phoenix, AZ · On-site

Phoenix , AZ Please find the JD Below The Risk Adjustment Analyst serves as a data and strategic specialist who tracks health plan performance and financial risk By using advanced coding ...

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How much do adjustment analyst jobs pay per year?

As of Aug 1, 2026, the average yearly pay for adjustment analyst in the United States is $73,261.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $87,000.00 per year, depending on experience, location, and employer.

What does an Adjustment Analyst do?

An Adjustment Analyst is responsible for reviewing, analyzing, and processing claims or financial transactions that require corrections or adjustments. They ensure the accuracy of billing, payments, or account records by identifying discrepancies and making necessary changes. Their work often involves communicating with internal departments or external clients to resolve issues efficiently and maintain accurate records. Adjustment Analysts play a key role in preventing financial errors and ensuring compliance with company policies and regulations.

What does a risk adjustment analyst do?

A risk adjustment analyst reviews healthcare data to assess the accuracy of patient risk scores used for reimbursement and quality measurement. They analyze medical records, coding, and claims data to identify discrepancies and ensure proper risk adjustment, often using specialized software and maintaining compliance with industry regulations.

What is the difference between Adjustment Analyst vs Claims Processor?

AspectAdjustment AnalystClaims Processor
Required CredentialsTypically requires a bachelor's degree in finance, accounting, or related fieldOften requires a high school diploma or equivalent; some roles prefer post-secondary education
Work EnvironmentOffice setting, analyzing financial data and making adjustmentsOffice setting, processing insurance claims and verifying information
Employer & IndustryInsurance companies, financial institutions, healthcare providersInsurance companies, healthcare providers, government agencies

Adjustment Analysts focus on reviewing and making financial adjustments based on data analysis, while Claims Processors handle the processing and verification of insurance claims. Both roles are common in insurance and healthcare industries and often require similar credentials, but their core responsibilities differ significantly.

What jobs in the US pay 300,000 a year?

Adjustment analysts typically do not earn $300,000 annually; high-paying roles in finance, medicine, law, and executive management often reach or exceed this level. Senior positions such as investment bankers, surgeons, corporate executives, and specialized attorneys are more likely to have salaries around or above this threshold, especially with experience and advanced certifications.

What jobs pay $500,000 a year in the US?

Adjustment analysts typically do not earn $500,000 annually; such high salaries are usually associated with executive roles, specialized surgeons, or successful entrepreneurs. High-paying jobs often require advanced skills, extensive experience, or ownership of a business. Compensation at this level is rare in standard analyst positions and more common in executive or highly specialized fields.

What are the key skills and qualifications needed to thrive as an Adjustment Analyst, and why are they important?

To thrive as an Adjustment Analyst, you need strong analytical skills, attention to detail, and a background in finance, accounting, or business administration. Familiarity with claims management systems, data analysis tools like Excel, and sometimes industry certifications such as AIC (Associate in Claims) are commonly required. Excellent communication, problem-solving abilities, and organizational skills help you collaborate with stakeholders and resolve discrepancies effectively. These skills and qualities are crucial for ensuring accurate claim adjustments, maintaining compliance, and supporting efficient business operations.

How does an Adjustment Analyst typically collaborate with other departments to resolve discrepancies?

Adjustment Analysts frequently work cross-functionally with finance, operations, and customer service teams to investigate and resolve discrepancies in billing, payments, or account records. Collaboration often involves gathering documentation, clarifying transaction details, and ensuring accurate adjustments are made in company systems. Effective communication and attention to detail are key, as analysts must coordinate findings and solutions to maintain financial accuracy and customer satisfaction. Regular meetings and shared digital tools are common practices to facilitate this teamwork.

Which analyst job pays the most?

Senior or specialized analyst roles, such as financial analysts, data analysts, or management analysts, tend to offer the highest salaries within the analyst job category. These positions often require advanced skills, certifications, and experience, and they typically pay more than entry-level or general analyst roles.
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Adjustment Analyst jobs near you
Infographic showing various Adjustment Analyst job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 14% Part Time, and 8% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $73,261 per year, or $35.2 per hour.

Risk Adjustment Analyst

Centrum Health

Doral, FL

Other

Re-posted yesterday

Job description

SCOPE OF ROLE 

The Risk Adjustment and Analytics Team is working to push boundaries to redefine Risk Adjustment and Quality Analytics in a Value-Based Care Setting. The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare, ACO REACH, MSSP, and Medicaid. The Risk Adjustment and Quality Analyst will be responsible for working both independently and collaboratively between multiple departments such as Analytics, Risk Adjustment and Quality, Medical Economics, & Clinical Operations.

This is an onsite position in Doral, FL.

ROLE RESPONSIBILITIES

  • Proactively collaborate and interact with business stakeholders across the organization to understand analytics needs, develop plans to address those needs, and deliver analytics to meet those needs.
  • Using SQL code, mine data on medical spend, clinical data and population health data and derive meaningful insights to improve operations such as trends, correlations and patterns.
  • Own the data. You are responsible for accurate presentation of your data elements, so ensuring data integrity is paramount.
  • Thoroughly analyze data, quickly identify relevant information, and transform it into a meaningful output.  Conduct thoughtful presentations, online or in person, to stakeholders with actionable findings for improvement.
  • Provide concise data reports and clear data visualizations for executive level reporting through Power BI, Excel and other tools used by the organization.
  • Create data processes that are consistent, repeatable, and scalable.
  • Conduct Quarterly Reconciliations to identify dropped HCCs and prepare supplemental data submission files according to payor partner specifications.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor's degree is required.
  • Comprehensive understanding of risk adjustment and quality programs across all government-regulated lines of business, including Marketplace, Medicaid, and Medicare programs.
  • Five (5) or more years of hands-on SQL code development is required, including expertise with programming languages like Scala or Python.
  • Three (3) or more years of experience in healthcare field dealing with claims/utilization as it pertains to Risk Adjustment and Quality.
  • Three (3) or more years of analytics experience (Required)
  • Two (2) or more years of Power BI experience (Required)
  • Experience with Databricks (Preferred)
  • Familiarity with CMS-HCC and HHS-HCC risk Adjustment Models
  • Familiarity with HEDIS and MSSP Quality Reporting

PROFESSIONAL COMPETENCIES

  • Expertise in analytics, statistics, data visualization, or programming
  • Dedicates exacting attention to detail and data quality
  • Eager learner, collaborative partner, easy communicator, and careful analyst
  • Passion for empirical research and answering hard questions with data

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