ZipRecruiter

Log In

1

Adjustment Rep Jobs (NOW HIRING)

Humana

Records Retrieval Specialist

York, 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

Carlisle, 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

Carlisle, 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

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 ...

Humana

Records Retrieval Specialist

York, 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

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

York, 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

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

Carlisle, 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 ...

previous page

Showing results 41-60

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 17, 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 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 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 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 Coding Coordinator (onsite), full time, days

Holland Hospital

Holland, MI • On-site

$23.30 - $34.95/hr

Full-time

Re-posted 6 days ago

Holland Hospital rating

6.5

Company rating: 6.5 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

721st of 1,060 rated hospitals

Job description

CURRENT HOLLAND HOSPITAL EMPLOYEES- Please apply through Find Jobs from your Workday employee account.
The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.
Qualifications:
Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hire
Experience with risk adjustment programs preferred.
Prior provider education or clinical collaboration experience preferred.
Excellent communication skills for provider education and stakeholder collaboration
Employment Type: Full Time
Shift: Mon-Thrs- 8am-4:30pm Fri- 8a-12p
Weekly Scheduled Hours: 36
Wage Range: $23.30 - $34.95 per hour
Weekend Requirements: NA
Requirements:
- High school diploma/GED or higher education
-Certified Professional Coder (C-CPC)
Clinical Documentation Review & Risk Adjustment Coding
  • Prepare and manage risk adjustment visit workflows, including maintaining patient lists, diagnosis summaries, and assisting with scheduling coordination.
  • Conduct comprehensive pre-visit chart reviews to identify and validate ICD-10-CM diagnoses that accurately represent each patient's health status.
  • Perform post-visit documentation analysis to ensure proper ICD-10-CM code assignment, diagnosis specificity, and compliance with MEAT (Monitor, Evaluate, Assess, Treat) criteria.
  • Maintain up-to-date knowledge of CMS risk adjustment regulations, HCC models, and clinical documentation and coding standards.
  • Support organizational value-based care goals by collaborating with Manager, Quality and clinical teams to ensure compliant risk adjustment documentation.

Provider Engagement, Education & Clinical Support
  • Serve as a clinical documentation and coding subject matter expert, supporting providers in achieving compliant and accurate risk adjustment practices.
  • Deliver ongoing education and feedback to providers and coders regarding documentation standards, diagnosis specificity, and optimal risk adjustment coding principles.
  • Identify documentation gaps or inconsistencies and communicate findings through structured, actionable feedback, including formalized documentation queries as needed.
  • Promote a culture of documentation excellence that supports quality outcomes, operational performance, and compliant value-based care delivery.

Audit, Reporting & Performance Monitoring
  • Conduct routine and targeted chart audits to assess documentation quality, coding accuracy, and HCC recapture performance.
  • Track, analyze, and report key risk adjustment performance indicators, including recapture rates, suspect condition closure, documentation accuracy, and provider-level trends.
  • Collaborate with operational leaders to integrate risk adjustment best practices into existing clinical workflows and identify opportunities for process improvement.
  • Participate in quality assurance initiatives, report findings to leadership, and support the development of corrective action plans or workflow enhancements.

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy

What Holland Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply