ZipRecruiter

Log In

1

Adjustment Rep Jobs (NOW HIRING)

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

The actual posting represents a position at one of our clients. Job Summary Our client is seeking a skilled Risk Adjustment Director to serve as the executive strategic leader and subject matter ...

Humana

Records Retrieval Specialist

Lancaster, PA · Remote

$40K - $52K/yr

As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect medical records and conduct research to ensure accuracy of member information and obtain provider ...

Aquity Solutions

Director Risk Adjustment - Remote

$130K - $150K/yr

Director of Risk Adjustment About IKS Health For more information, visit: www.ikshealth.com IKS ... Partner cross-functionally with the Product team as the primary business stakeholder representing ...

Cano Health

Risk Adjustment Coder

Jupiter, FL · On-site

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... The physical demands described here are representative of those that must be met by an employee to ...

Humana

Records Retrieval Specialist

Harrisburg, PA · Remote

$40K - $52K/yr

As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect medical records and conduct research to ensure accuracy of member information and obtain provider ...

Humana

Records Retrieval Specialist

Mechanicsburg, PA · Remote

$40K - $52K/yr

As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect medical records and conduct research to ensure accuracy of member information and obtain provider ...

Humana, Inc.

Records Retrieval Specialist

York, PA · On-site

$40K - $52K/yr

As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect medical records and conduct research to ensure accuracy of member information and obtain provider ...

Humana

Records Retrieval Specialist

Lancaster, PA · Remote

$40K - $52K/yr

As the Medical Records Retrieval Specialist (Risk Adjustment Representative 2) you will: * Collect medical records and conduct research to ensure accuracy of member information and obtain provider ...

Cano Health

Risk Adjustment Coder

Jupiter, FL

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... The physical demands described here are representative of those that must be met by an employee to ...

Cano Health

Risk Adjustment Coder

Jupiter, FL · On-site

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... The physical demands described here are representative of those that must be met by an employee to ...

previous pagenext page

Showing results 21-40

All JobsAdjustment Rep Jobs

Adjustment Rep information

See salary details

$14

$20

$29

How much do adjustment rep jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for adjustment rep in the United States is $20.39, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $20.19 per hour, depending on experience, location, and employer.

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

To thrive as an Adjustment Representative, you need strong analytical skills, attention to detail, and a solid understanding of insurance or billing processes, typically supported by a high school diploma or relevant experience. Familiarity with claims management software, spreadsheets, and customer relationship management (CRM) systems is commonly required. Excellent communication, problem-solving, and negotiation skills help you resolve discrepancies and build positive client relationships. These abilities ensure accurate claim adjustments, regulatory compliance, and high levels of customer satisfaction.

What are some common challenges adjustment reps face when handling complex claims, and how can they effectively manage them?

Adjustment Representatives often encounter challenges such as ambiguous documentation, tight deadlines, and navigating conflicting information from clients and providers. To manage these effectively, it's important to maintain strong organizational skills, communicate clearly with all parties involved, and stay current on company policies and industry regulations. Collaborating closely with team members and leveraging available resources, such as claim management software, can also help streamline the resolution process and ensure accuracy.

What is an adjustment rep?

An Adjustment Rep, or Adjustment Representative, is a professional who reviews and processes claims, typically in insurance or finance industries. They investigate discrepancies, verify documentation, and determine if adjustments are needed to correct billing errors or resolve disputes. Their role often involves communicating with customers, analyzing data, and ensuring compliance with company policies and regulations. Adjustment Reps play a crucial part in maintaining customer satisfaction by addressing and resolving issues efficiently.

What is the difference between Adjustment Rep vs Claims Processor?

AspectAdjustment RepClaims Processor
Required CredentialsHigh school diploma; insurance knowledgeHigh school diploma; insurance knowledge
Work EnvironmentOffice-based, insurance companiesOffice-based, insurance companies
Employer & IndustryInsurance providers, healthcareInsurance providers, healthcare
Common Search & ComparisonAdjustment Rep vs Claims Processor

Adjustment Representatives and Claims Processors both work within the insurance industry, often in similar office environments. They typically require comparable credentials, such as a high school diploma and insurance knowledge. The main difference lies in their specific roles: Adjustment Reps focus on reviewing and adjusting claims, while Claims Processors handle the initial processing of claims. Understanding these distinctions can help job seekers identify the right career path within insurance roles.

More about Adjustment Rep jobs

What job categories do people searching Adjustment Rep jobs look for?

The top searched job categories for Adjustment Rep jobs are:

Adjustment Rep jobs near you
Infographic showing various Adjustment Rep job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 15% Part Time, 7% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $42,416 per year, or $20.4 per hour.

Risk Adjustment Director

Medix

Scotts Valley, CA • On-site

$96.15 - $120.19/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 22 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a skilled Risk Adjustment Director to serve as the executive strategic leader and subject matter expert for the health plan's Risk Adjustment Department. The primary responsibilities include designing and overseeing data strategies to ensure accurate member health coding, managing financial impacts of risk scores, leading a team, and acting on behalf of the CFO when necessary.
Responsibilities / Job Duties
  • Build the roadmap for the health plan's risk adjustment goals to improve data collection, reporting, and auditing.
  • Track risk scores and work closely with Actuaries and Financial Planning & Analysis to align with budgets.
  • Optimize Risk Adjustment Factor improvements through external vendors.
  • Partner with the Provider Relations Director to train and support doctors on compliant, accurate medical record coding.
  • Hire, train, mentor, and evaluate a team of risk adjustment professionals.
  • Formulate and manage the Risk Adjustment Department's operational budget.
  • Oversee Medicare DSNP Risk Adjustment strategy and execution.
  • Directly support key operational initiatives to ensure program stability and scalability.

Minimum Education and Experience Qualification Requirements
Education
  • Bachelor's degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field.

Qualifications
  • 10 years of experience in healthcare finance or analytics.
  • 5 years of experience with Medicare risk adjustment processes.
  • 2 years of experience related to Medicare Managed Care Programs.
  • 3 years of supervisory experience.
  • Expert knowledge of Medicare HCC risk adjustment models.
  • Working knowledge of CPT, HCPCS, and ICD-9/10 medical coding.
  • Familiarity with data analytical tools like SQL and visualization platforms like Tableau.

Skills
  • Technical proficiency in data analytical tools and coding methodologies.
  • Strong leadership and team management skills.
  • Excellent communication and organizational abilities.

Schedule / Shift
Mon-Fri 8am-5pm (potential for some flexibility for early/later start upon discussion)
Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

Required Employment / Compliance Language
Medix is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients
Medix Staffing Solutions logo

About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

View All Medix Staffing Solutions Jobs

Apply