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Certified Risk Adjustment Coder Jobs in Iowa (NOW HIRING)

University of Iowa

CDI Quality Analyst

Iowa City, IA · On-site

... coders to clarify at-risk documentation to ensure accurate claim submission (American Health ... Must obtain CCDS (Certified Clinical Documentation Specialist) certification within 3 years of hire.

University of Iowa

CDI Quality Analyst

Iowa City, IA

... coders to clarify at-risk documentation to ensure accurate claim submission (American Health ... Must obtain CCDS (Certified Clinical Documentation Specialist) certification within 3 years of hire.

Varsity Tutors

Finance Tutor

Iowa City, IA · Remote

$40/hr

... certification examinations. * Conceptual Teaching & Problem-Solving: Skilled at breaking down ... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ...

Varsity Tutors

Finance Tutor

Ames, IA · Remote

$40/hr

... certification examinations. * Conceptual Teaching & Problem-Solving: Skilled at breaking down ... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ...

University of Iowa

Compliance Risk Auditor

Iowa City, IA · On-site

Adhere to audit scope and perform high level, self-guided research on all required topics (coding ... Certification as RHIT, RHIA, CPC, or equivalent through a nationally recognized credentialing body ...

Thedacare

Coding Auditor

Manchester, IA · On-site

$24.50 - $28/hr

Responds to identified areas of risk through investigation and internal audit to ensure compliance ... Coder/AAPC), CIC (Certified Inpatient Coder/AAPC), or COC (Certified Outpatient Coder/AAPC)

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Certified Risk Adjustment Coder information

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$16

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$66

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

As of Jun 22, 2026, the average hourly pay for certified risk adjustment coder in Iowa is $27.51, according to ZipRecruiter salary data. Most workers in this role earn between $20.53 and $27.31 per hour, depending on experience, location, and employer.

Is HCC coding a good career?

Certified Risk Adjustment Coders (HCC coders) play a vital role in healthcare billing and reimbursement by accurately coding patient diagnoses for risk adjustment models. The field offers steady demand, opportunities for certification, and potential for career advancement, especially with experience and specialized knowledge of coding systems and healthcare regulations.

How to become a certified risk adjustment coder?

To become a certified risk adjustment coder, you need to complete relevant training or coursework in medical coding and risk adjustment, and then pass a certification exam such as the Certified Risk Adjustment Coder (CRC) offered by the American Academy of Professional Coders (AAPC). Maintaining the certification typically requires ongoing education and adherence to industry standards. Strong knowledge of medical terminology, coding guidelines, and health insurance processes is essential for success in this role.

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 pays more, CCS or CPC?

Certified Risk Adjustment Coders (CRC) and Certified Professional Coders (CPC) are both coding certifications, but CPCs generally tend to have higher average salaries due to broader coding responsibilities and demand. Salary differences can also depend on experience, location, and employer, with CPCs often earning more in outpatient and physician office settings. Both certifications can lead to higher pay when combined with relevant experience and specialized skills.

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 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.

What is the highest salary for a CPC coder?

Certified Risk Adjustment Coders (CPCs) typically earn salaries ranging from $50,000 to over $80,000 annually, with top earners in specialized or senior roles reaching higher figures. Factors such as experience, certifications, and work environment influence salary levels in this field.
What are popular job titles related to Certified Risk Adjustment Coder jobs in Iowa? For Certified Risk Adjustment Coder jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Certified Risk Adjustment Coder jobs in Iowa look for? The top searched job categories for Certified Risk Adjustment Coder jobs in Iowa are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in Iowa as of June 2026, with employment types broken down into 1% Locum Tenens, 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $57,220 per year, or $27.5 per hour.
Manager of Payment Integrity

Manager of Payment Integrity

Medical Associates

Dubuque, IA

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 19 days ago

Job description

Medical Associates Health Plans is hiring a Manager of Payment Integrityto join our team!
Where You Will Be Working:
Medical Associates Clinic and Health Plans is a multi-specialty group practice combined with a growing health insurance company. Our 1,100 healthcare and health insurance professionals lead the way in providing quality healthcare and top-notch insurance products in Northeast Iowa, Southwest Wisconsin, and Northwest Illinois. This position is an onsite positionlocated at the Medical Associates Health Plans in Dubuque, Iowa.
Benefits Package Includes:
  • Single or Family Health Insurance with discounted premium rates for wellness program participation.
  • 401k with immediate matching (50% on the dollar up to 7% of pay) + additional annual Profit Sharing
  • Flexible Paid Time Off Program (29 days off/year)
  • Medical and Dependent Care Flex Spending Accounts
  • Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.
Major Responsibilities:
  • Program Leadership and Staff Supervision
    Supervise payment integrity-related staff, including roles supporting clinical documentation, coding, and claims audit functions. Provide coaching, mentoring, performance feedback, and professional development. Oversee daily workflows related to claim audits, risk adjustment validation, large claim reviews, appeals, and recoveries. Establish priorities, assign work, monitor productivity and quality standards, and implement process improvements to enhance efficiency, accuracy, and compliance. Serve as a subject matter resource for payment integrity policies, audit methodologies, and payerspecific requirements.
  • Claims Audit and Payment Validation Activities
    Conduct detailed, linebyline medical and ancillary claim audits using associated medical records, coding guidelines, and provider contracts. Validate medical necessity when applicable, confirm correct coding and reimbursement, and identify overpayments or underpayments. Investigate discrepancies, document findings, and collaborate with internal departments and providers to support corrections, recoveries, and process improvement.
  • Large Claim, Risk Adjustment, and Reinsurance Support
    Provide targeted oversight of highdollar claims (greater than $50,000), including pre and postpayment review. Support risk adjustment accuracy through validation of diagnosis coding and documentation. Coordinate with Finance and Claims to support reinsurance identification, documentation, and submission processes.
  • Payment Integrity Program Oversight, Appeals, and Provider Collaboration
    Oversee the relationship and performance of payment integrity consultants and vendors, including management of workflows, audit tools, and program policies to ensure accuracy, effectiveness, and annual updates. Lead and support payment integrity-related appeals, including review of cases, development of rationale, and preparation of supporting documentation. Coordinate with internal stakeholders to ensure consistency in determinations and alignment with program goals. Collaborate with Provider Relations and Contracting to support provider communication, education, and issue resolution related to billing practices, documentation, and audit findings.
  • Fraud, Waste, and Abuse (FWA) Collaboration
    Identify potential FWA indicators through audit and analytical activities. Collaborate with the Special Investigations Unit (SIU) by referring suspected FWA cases and supporting investigations as requested.
  • Reporting, Compliance, and Other Duties
    Prepare summary data and reporting for leadership, including audit outcomes, financial impact, trends, and improvement opportunities. Maintain accurate audit records and ensure adherence to federal, state, and payerspecific regulations. Complete additional projects and duties as assigned.
Knowledge and Skills:
Experience Three to five years of similar or related experience
Education Equivalent to a twoyear college degree or completion of a specialized course of study or certification at a business or trade school. Valid RN license is required; medical coding experience is preferred.
Interpersonal Skills A significant level of trust and diplomacy is required, in addition to normal courtesy and tact. Work involves extensive personal contact with others and/or is usually of a personal or sensitive nature. Work may involve motivating or influencing others. Outside contacts become important and fostering sound relationships with other entities (companies and/or individuals) becomes necessary.
Employment Type: Full-Time

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