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Adjustment Analyst Jobs (NOW HIRING)

Datavant

Risk Adjustment Data Analyst

Dallas, TX · Remote

Experience and familiarity with MA, ACA and Medicaid Risk Adjustment models. * Experience with other business intelligence backend and analytics applications * Familiarity with or interest in ...

P3 Health Partners

MRA Encounter Analyst

Henderson, NV · On-site

$80K - $90K/yr

Overall Purpose The primary role of the Risk Adjustment Encounter Analyst (RAA) will be to function as the encounter SME for P3. The RAA implements data analytic reports, as well as analyzes and ...

P3 Health Partners

MRA Encounter Analyst

Henderson, NV · On-site +1

$80K - $90K/yr

Overall Purpose The primary role of the Risk Adjustment Encounter Analyst (RAA) will be to function as the encounter SME for P3. The RAA implements data analytic reports, as well as analyzes and ...

Pacer Group

Field Support Analyst I

Forest Park, GA · On-site

$23 - $26/hr

Investigate discrepancies and perform billing adjustments with proper approvals * Research ... Analytical thinking and problem-solving skills * Strong communication and organizational abilities ...

Point32Health

Risk Adjustment Consultant

Canton, MA · On-site

The Risk Adjustment Consultant will also work closely with our Network Contracting, Clinical and ... Analyze, interpret and synthesize medical group specific results and risk score trend information ...

Interwell Health

Director, Risk Adjustment

Leverage analytics, predictive modeling, and external vendor partnerships to enhance suspecting ... Expand risk adjustment execution beyond nephrology by developing scalable processes to engage ...

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Adjustment Analyst information

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$31K

$73.3K

$130K

How much do adjustment analyst jobs pay per year?

As of May 31, 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 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.

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.

How much do risk adjustment coders make in the US?

Risk adjustment coders, including Adjustment Analysts, typically earn between $50,000 and $75,000 annually in the US, depending on experience, certification, and location. Salaries can vary based on the complexity of coding, employer size, and whether the role is remote or onsite.

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.

More about Adjustment Analyst jobs
What job categories do people searching Adjustment Analyst jobs look for? The top searched job categories for Adjustment Analyst jobs are:
Adjustment Analyst jobs near you
Infographic showing various Adjustment Analyst job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 75% Physical, 6% Hybrid, and 19% Remote job distribution, with an average salary of $73,261 per year, or $35.2 per hour.

Risk Adjustment Associate Data Analyst (Medicare)- Hybrid

UPMC Senior Communities

Pittsburgh, PA • On-site

$27.89 - $48.21/hr

Full-time

Posted 11 days ago

Job description

We are seeking a Risk Adjustment Associate Data Analyst to support Medicare Advantage (MA) and ACA Commercial risk adjustment programs. This role is responsible for producing accurate reporting, performing analytical reviews, and reconciling CMS and HHS risk adjustment response files. The analyst will work closely with senior analysts, operations teams, and business partners to support risk score accuracy, coding performance, and financial outcomes. This position focuses on foundational analytics and reporting rather than advanced predictive modeling and is ideal for an analyst with healthcare data experience and working knowledge of Medicare and ACA risk adjustment methodologies.
This is a Monday through daylight role and will be a hybrid shift consisting of working from home and in office.
Responsibilities:
  • Perform analytics and reporting for Medicare Advantage and ACA risk adjustment programs.
  • Analyze claims and clinical data to monitor risk score performance and identify trends or issues.
  • Reconcile CMS MA and HHS EDGE response files; investigate and document submission discrepancies Use SQL to query, validate, and analyze healthcare data for recurring and ad hoc reporting.
  • Develop and maintain reports and dashboards using Power BI or similar tools.
  • Summarize and communicate analytical findings to business and operational stakeholders.
  • Collaborate with analytics, data engineering, and risk adjustment operations teams.
  • Document methodologies and support continuous improvement of reporting processes

Qualifications:
  • Bachelors degree in a quantitative or health-related field required.
  • 1-3 years of experience in risk adjustment reporting and analytics.
  • Equivalent education and experience considered.
  • Working knowledge of Medicare Advantage and ACA risk adjustment programs.
  • Understanding of CMS HCC and HHS HCC methodologies.
  • Experience reconciling CMS and/or HHS risk adjustment response files.
  • Strong SQL proficiency for healthcare data analysis.
  • Ability to interpret and clearly communicate analytical results.

Preferred Qualifications:
  • Experience with Snowflake.
  • Exposure to Python for analysis or automation.
  • Experience with Power BI or similar reporting tools.
  • Familiarity with claims and clinical data
    Licensure, Certifications, and Clearances:
  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

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