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Certified Risk Adjustment Coder Jobs (NOW HIRING)

Boston Medical Center

Risk Adjustment Coder

$19.25 - $25.50/hr

Certification may include Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) and/or Certified Clinical Documentation Specialist- Outpatient or Certified Documentation Expert ...

Strive Health

Risk Adjustment Coder

Denver, CO · Remote

$27.88 - $32.21/hr

Active, approved CRC (Certified Risk Adjustment Coder) or CPC (Certified Professional Coder) License. From AAPC or AHIMA. * 5+ years combined of related education, coding/auditing experience, or ...

Strive Health

Risk Adjustment Coder

Denver, CO · On-site

$19.25 - $25.75/hr

Active, approved CRC (Certified Risk Adjustment Coder) or CPC (Certified Professional Coder) License. From AAPC or AHIMA. * 5+ years combined of related education, coding/auditing experience, or ...

Apex Health Solutions

Certified Medical Coder

Houston, TX · On-site

$21.50 - $29.25/hr

Summary Certified Medical Coder role is responsible for reviewing, abstracting, and coding ... Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world ...

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How much do certified risk adjustment coder jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for certified risk adjustment coder in the United States is $29.29, according to ZipRecruiter salary data. Most workers in this role earn between $21.88 and $29.09 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Certified Risk Adjustment Coder, and why are they important?

To thrive as a Certified Risk Adjustment Coder, you need expertise in medical coding, a thorough understanding of ICD-10-CM guidelines, and certification such as CRC (Certified Risk Adjustment Coder). Familiarity with coding software, electronic health records (EHRs), and risk adjustment models like HCC is typically required. Attention to detail, analytical thinking, and strong communication skills help ensure accurate code assignment and effective collaboration with healthcare providers. These skills and qualifications are crucial for capturing precise patient data, which directly impacts healthcare reimbursement and compliance.

What are some common challenges Certified Risk Adjustment Coders face, and how can they overcome them?

Certified Risk Adjustment Coders often encounter challenges such as staying current with evolving coding guidelines and accurately interpreting complex medical records. To overcome these difficulties, coders should regularly participate in ongoing education, leverage resources from professional organizations, and collaborate closely with providers to clarify documentation. Maintaining a strong attention to detail and utilizing coding software tools can also help minimize errors and improve coding accuracy. Engaging in peer reviews within the team can further enhance consistency and knowledge sharing.

What is a Certified Risk Adjustment Coder?

A Certified Risk Adjustment Coder is a professional who specializes in reviewing and coding medical records to ensure accurate documentation of diagnoses for risk adjustment purposes. These coders play a crucial role in healthcare reimbursement, especially for Medicare Advantage and other risk-adjusted health plans. They analyze patient records using ICD-10-CM codes to help healthcare organizations receive appropriate compensation based on the severity of patient conditions. Certified Risk Adjustment Coders typically hold certifications such as the CRC from the AAPC, demonstrating their expertise in this specialized field.

What is the difference between Certified Risk Adjustment Coder vs Certified Medical Coder?

AspectCertified Risk Adjustment CoderCertified Medical Coder
CertificationsRequires risk adjustment-specific credentials like RAC, CRC, or CPC-RRequires CPC or CCS certifications
Work EnvironmentPrimarily in health insurance, risk adjustment, and payer settingsHospitals, clinics, physician offices, and outpatient facilities
Industry UsageUsed mainly in health insurance and risk adjustment programsUsed across healthcare providers for medical coding and billing

The Certified Risk Adjustment Coder specializes in coding for risk adjustment programs within health insurance, focusing on accurate documentation for reimbursement. In contrast, the Certified Medical Coder works across various healthcare settings, primarily coding diagnoses and procedures for billing. While both roles require coding certifications, their focus areas and work environments differ significantly.

More about Certified Risk Adjustment Coder jobs
What cities are hiring for Certified Risk Adjustment Coder jobs? Cities with the most Certified Risk Adjustment Coder job openings:
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What job categories do people searching Certified Risk Adjustment Coder jobs look for? The top searched job categories for Certified Risk Adjustment Coder jobs are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 13% Physical, and 87% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.
Risk Adjustment Coder

Risk Adjustment Coder

Boston Medical Center

Remote

$19.25 - $25.50/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

Boston Medical Center rating

7.0

Company rating: 7.0 out of 10

Based on 105 frontline employees who took The Breakroom Quiz

474th of 991 rated hospitals

Job description

POSITION SUMMARY:
The Risk Adjustment Coder determines the appropriate ICD10-CM diagnoses codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for risk adjustment and Hierarchical Condition Categories (HCC). Risk adjustment coding relies on ICD-10-CM coding to assign risk scores to patients. The incumbent reviews retrospective medical record documentation and ensures that the codes are appropriately assigned. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of both the facility and the physicians. The Risk Adjustment Coder utilizes standards of compliance, specifically in OP compliant query processes and clinical knowledge to identify opportunities and to achieve results Also required is advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems.
Position: Risk Adjustment Coder
Department: Clinical Documentation
Schedule: Full Time
ESSENTIAL RESPONSIBILITIES / DUTIES:
  • Review documentation available in the Medical Record to facilitate workflows that support the clinical picture/severity of illness/complexity of the patient care rendered to patients.
  • Reviews medical records to ensure accurate codes are applied to the encounter.
  • Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM diagnosis codes mapped to HCCs or other RA methodologies
  • Actively participate in and maintain coding quality and productivity processes
  • Collaborates with nursing or coding staff on retrospective medical record review for severity, accuracy, and quality issues.
  • Ensure documentation in the medical record follows the official coding guidelines, internal guidelines and the
  • AHIMA/ACDIS physician query brief.
  • Create and analyze reports for coding improvement trending and high-level dashboards for ongoing monitoring and opportunities.
  • Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements.
  • Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures related to billing.
  • Participate in training new coding staff, as needed. IND123

JOB REQUIREMENTS
EDUCATION:
  • High school diploma or equivalent medical coding education.
  • Associates Degree preferred (or direct work experience equivalent to at least 2 years)

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
  • Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) and/or Certified Clinical Documentation Specialist- Outpatient or Certified Documentation Expert Outpatient (CDEO) Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA), or Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) required

EXPERIENCE:
  • Minimum of two (2) years progressive coding experience in multiple specialties, HCC Risk adjustment Coding

KNOWLEDGE AND SKILLS:
  • Willing to work as a team - innovation and collaboration is a priority
  • Experience with an Electronic Medical Record (EMR), EPIC preferred
  • Knowledge of AHA coding guidelines and methodologies: HCC's and other RA methodologies, ICD-10-CM coding guidelines, Office of Inspector General (OIG) and Federal and State regulations
  • Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results
  • Strong organization and analytical thinking skills - detail oriented
  • Proficient with Microsoft Office applications (Outlook, Word, Excel)
  • Demonstrates critical thinking skills, able to assess, evaluate, and teach
  • Self-motivated and able to work independently without close supervision
  • Strong communication skills (interpersonal, verbal and written)
  • Medical Record audits and review
  • Familiarity with the external reporting aspects of healthcare
  • Familiarity with the business aspects of healthcare, including prospective payment systems
  • Proficient with computer applications (MS Office etc.), Excellent data entry skills
  • Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
  • Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
  • Ability to work with accuracy and attention to detail
  • Ability to solve problems appropriately using job knowledge and current policies/procedures.
  • Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
  • Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.

Compensation Range:
$24.04- $33.65
This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.
NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.
Equal Opportunity Employer/Disabled/Veterans
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or "apps" job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

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About Boston Medical Center

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Boston Medical Center (BMC) is more than a hospital. It's a network of support and care that touches the lives of hundreds of thousands of people in need each year. It is the largest and busiest provider of trauma and emergency services in New England. Emphasizing community-based care, BMC is committed to providing consistently excellent and accessible health services to all-and is the largest safety-net hospital in New England. The hospital is also the primary teaching affiliate of the nationally ranked Boston University School of Medicine (BUSM) and a founding partner of Boston HealthNet - an integrated health care delivery systems that includes many community health centers. Join BMC today and help us achieve our Vision 2030 which is a long-term goal to make Boston the healthiest urban population in the world.

Industry

Hospitals

Company size

1,001 - 5,000 Employees

Headquarters location

Boston, MA, US

Year founded

1996

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