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Certified Risk Adjustment Coder Jobs in Illinois

Bcbsa

Head of Medicare Performance Hub

Chicago, IL · On-site

CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization ... certifications, relevant experience, skills, seniority, performance, shift, travel requirements ...

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Certified Risk Adjustment Coder information

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$16

$28

$68

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

As of Sep 12, 2026, the average hourly pay for certified risk adjustment coder in Illinois is $28.38, according to ZipRecruiter salary data. Most workers in this role earn between $21.20 and $28.17 per hour, depending on experience, location, and employer.

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 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 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.

How do you become a certified risk adjustment coder?

To become a certified risk adjustment coder, you typically need to complete relevant training or coursework in medical coding and risk adjustment, gain experience in medical billing or coding, and pass a certification exam such as the Certified Risk Adjustment Coder (CRC) offered by the American Academy of Professional Coders (AAPC). Continuing education is often required to maintain certification and stay current with industry updates.

Is certified risk adjustment coding a good career?

Certified risk adjustment coding is a growing field within healthcare, focusing on accurately coding patient diagnoses for insurance reimbursement and risk assessment. It requires knowledge of medical terminology, coding systems like ICD-10, and often involves certification such as the RAC or CRC. The role offers stable employment opportunities, competitive salaries, and the potential for remote work, making it a viable career choice for those interested in healthcare administration and coding.

What are popular job titles related to Certified Risk Adjustment Coder jobs in Illinois?

For Certified Risk Adjustment Coder jobs in Illinois, the most frequently searched job titles are:

What job categories do people searching Certified Risk Adjustment Coder jobs in Illinois look for?

The top searched job categories for Certified Risk Adjustment Coder jobs in Illinois are:

What cities in Illinois are hiring for Certified Risk Adjustment Coder jobs?

Cities in Illinois with the most Certified Risk Adjustment Coder job openings:

Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in Illinois as of August 2026, with employment types broken down into 2% As Needed, 72% Full Time, 20% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $59,033 per year, or $28.4 per hour.

CERTIFIED PROFESSIONAL CODER (ON-SITE)

Kankakee, IL • On-site

Riverside Healthcare
See more jobs at Riverside Healthcareexternal

$21.75 - $29/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Job description

Overview
The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.
Essential Duties
  • Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed
  • Reviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation (e.g., current coding conventions, regulatory/payor-specific requirements, risk-adjustment guidelines, organization-specific policies) to support findings and use as reference
  • Documents audit results in designated Excel log as soon as review is completed
  • Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management
  • Assists coding compliance lead in creating and publishing monthly provider newsletter
  • Collaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teams
  • Participates in developing and presenting provider and coder education programs as requested
  • Assists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirements
  • Assists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requested
  • Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
  • Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies
Responsibilities
Required Experience
  • Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience required
Required Licensure/Education
  • High school graduate or equivalent required.
  • AAPC/CPC (Certified Professional Coder) required
  • AAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hire
  • AAPC/CRC (Certified Risk-Adjustment Coder) strongly recommended
Preferred Education
  • Associate degree in health-related field preferred
  • Formal education in ICD-10-CM and CPT/HCPCS coding principles and assignment maintained by relevant continuing education
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable. Our Total Rewards package includes:
Compensation:
  • Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or trainin
  • Premium pay such as shift differential, on-call
  • Opportunity for annual increases based on performance
Benefits - .5 to 1.0 FTE:
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program
Benefits - .001 to .49 FTE:
  • Paid Leave Hours accrued as you work
Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
  • Chemicals: NA
  • Video Display Terminals: Average
  • Blood and Body Fluids: None
  • TB or Airborne Pathogens: None
Sensory requirements (speech, vision, smell, hearing, touch):
  • Speech: Needed for presentations/training, telephone communication, facilitate meetings.
  • Vision: Needed to read computer screens and printouts, memos, communications, documentation, and literature.
  • Smell: Electrical/fire safety.
  • Hearing: Needed for telephone communications, meetings, and equipment operating characteristics.
  • Touch: Needed to write, do computer entry, filing.
Activity/Lifting Requirements:
Percentage of time during the normal workday the employee is required to:
  • Sit: 55%
  • Twist: 0%
  • Stand: 20%
  • Crawl: 0%
  • Walk: 20%
  • Kneel: 0%
  • Lift: 0%
  • Drive: 0%
  • Squat: 0%
  • Climb: 0%
  • Bend: 5%
  • Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
  • Up to 10 lbs: Frequently
  • Up to 20 lbs: Occasionally
  • Up to 35 lbs: Occasionally
  • Up to 60 lbs: Occasionally
  • Up to 75 lbs: Not Required
  • Up to 100 lbs: Not Required
  • Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
  • Putting away supplies.
  • Lift above the head occasionally to place boxes on high storage shelves.
  • Carry boxes up and down the stairs - distances up to 100 feet.
Maximum consecutive time (minutes) during the normal workday for each activity:
  • Sit: 30
  • Twist: .5
  • Stand: 30
  • Crawl: 0
  • Walk: 2
  • Kneel: 0
  • Lift: 5
  • Drive: 30
  • Squat: 1
  • Climb: .5
  • Bend: .5
  • Reach above shoulders: .5
Repetitive use of hands (Frequency indicated):
  • Simple grasp up to 15 lbs.
  • Normal weight: continuous
  • Pushing &pulling Normal weight: 50-200#
  • Fine Manipulation: Computer Keyboard and mouse.
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards:
  • Environmental Factors (Time Spent):
    • Inside hours: 8.0
    • Outside hours : 0
  • Temperature: Normal Range
  • Lighting: Average
  • Noise levels: Average
  • Humidity: Normal
  • Atmosphere:
  • Special Hazards:
  • Protective Clothing Required: Gloves when handling blood and body fluids.

Pay Range
USD $28.83 - USD $37.13 /Hr

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