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Certified Risk Adjustment Coder Jobs in Michigan

MyMichigan Health

HCC Coder

Midland, MI · On-site

$16 - $21.50/hr

... Risk Adjustment Factor (RAF) scores (25%) Understands risk adjusted payment methodologies, HCC ... Certifications and Licensures E/M CODER: CPC, CCS, CCSP, RHIT, OR RHIA One of the following ...

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All JobsCertified Risk Adjustment Coder JobsCertified Risk Adjustment Coder Jobs in Michigan

Certified Risk Adjustment Coder information

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$14

$25

$61

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

As of Jun 15, 2026, the average hourly pay for certified risk adjustment coder in Michigan is $25.53, according to ZipRecruiter salary data. Most workers in this role earn between $19.09 and $25.34 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 Michigan? For Certified Risk Adjustment Coder jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Certified Risk Adjustment Coder jobs in Michigan look for? The top searched job categories for Certified Risk Adjustment Coder jobs in Michigan are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in Michigan as of June 2026, with employment types broken down into 1% Locum Tenens, 1% As Needed, 80% Full Time, 13% Part Time, and 5% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $53,097 per year, or $25.5 per hour.
Risk Adjustment Compliance Coder

Risk Adjustment Compliance Coder

Upper Peninsula Health Plan

Marquette, MI • Remote

$28.86/hr

Full-time

Posted 12 days ago

Job description

DATE: June 4, 2026POSITION:  Risk Adjustment Compliance CoderDEPARTMENT:  Finance-Risk AdjustmentRATE: $28.86 per hour, with potential for additional compensation based on qualifications. POSITION SUMMARY: 
The Risk Adjustment Compliance Coder is responsible for enhancing the accuracy, quality, and integrity of coding data that supports Medicare and Medicaid reimbursement. This role conducts risk adjustment coding audits, performs compliance research, responds to coding inquiries, and serves as a subject matter expert in risk adjustment coding and compliance. The position supports Medicare and Medicaid risk adjustment programs through the development, implementation, and ongoing evaluation of program initiatives. Highly collaborative and operational in nature, this role partners closely with providers and internal stakeholders and requires strong communication, education, and relationship-management skills. This is not a traditional production-focused coding position. 
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Follows established Upper Peninsula Health Plan (UPHP) policies and procedures, objectives, safety standards, and sensitivity to confidential information.
 
2. Collaborates with Risk Adjustment Analyst to develop, implement, and continually refine internal prospective and retrospective chart review programs and related risk adjustment initiatives.
 
3. Follows International Classification of Diseases (ICD)-10 guidelines for Coding and Reporting, Centers for Medicare & Medicaid Services (CMS) risk adjustment guidelines, and demonstrates knowledge of Current Procedural Terminology (CPT) coding. Understands the impact of ICD-10 coding on the CMS Hierarchical Condition Categories (HCC) risk adjustment model, and serves as the subject matter expert for risk adjustment activities.
 
4. Supports risk adjustment compliance and program integrity activities, including RADV preparedness, high-risk diagnosis review and validation, audit support, and identification and escalation of potential coding or documentation compliance concerns.
 
5. Assists with extraction of charts via remote Electronic Medical Record (EMR) access or faxed medical record request for risk adjustment initiatives.
 
6. Performs comprehensive medical record review, verifying and ensuring accuracy, completeness, specificity, and appropriateness of diagnoses codes in accordance with ICD-10 guidelines based on medical record documentation. Documents trends, observations, and potential coding or documentation improvement opportunities identified during the review process.
 
7. Maintains a comprehensive tracking and management tool to track all coding activities; generates and maintains accurate weekly, monthly, and quarterly reports of activities.
 
8. Assists with chart review encounter data submissions to CMS based on chart review findings.
 
9. Provides support during the annual retrospective chart review performed by an external party.
 
10. Identifies, develops, and delivers general and specific educational guidance to providers and clinic staff through webinars, newsletters, presentations, and other educational forums based on risk adjustment audit findings, CMS guidelines, regulatory requirements, and industry best practices.
 
11. Collaborates with internal departments, as appropriate, to carry out risk adjustment program activities to ensure integrity of diagnoses attributed to members submitted to the Michigan Department of Health and Human Services (MDHHS) and CMS by UPHP.
 
12. Collaborates with healthcare leaders, physicians, and provider office personnel to improve the accuracy and completeness of diagnosis code capture. Facilitates provider education, documentation clarification, and coding-related discussions in a professional, consultative manner to support risk adjustment and compliance objectives. 
 
13. Maintains confidentiality of client data.
 
14. Performs other related duties as assigned or requested.
POSITION QUALIFICATIONS:Education:Minimum:
High School Diploma
 Preferred:
Associate degree in business, health information processing, or related field 
 Certification:Minimum:
Must possess and maintain an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) certification—Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), or Certified Risk Adjustment Coder (CRC)
 Preferred:
Certified Coding Specialist (CCS-P, CCS, CPC) and Certified Risk Adjustment Coder (CRC)
 
Experience:Minimum:
Two (2) years of experience in medical chart coding
 Preferred:
Five (5) years of experience in medical chart coding, including inpatient and outpatient settings; working knowledge of managed care and health plan standards on Risk Adjustment Coding
 
Other Qualifications:
Knowledge and understanding of medical terminology, disease process, and anatomy and physiology
Advanced knowledge and understanding of CPT coding across a wide variety of provider specialties
 Required Skills:
Excellent organizational abilities with attention to detail
Ability to effectively communicate with, and educate, clinic staff (provider, care managers, clinic quality leads, etc.)
Working knowledge of Microsoft Office (Word, Excel, Outlook)
Keyboarding proficiency
Research and analytical skills
 Preferred Skills:
Knowledge of MS PowerPoint
Oriented to managed care
 
The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job-related selection or promotional criteria.
 
Physical Requirements: 
[This job requires the ability to perform the essential functions contained in the description. These include, but are not limited to, the following requirements. Reasonable accommodations may be made for otherwise qualified applicants unable to fulfill one or more of these requirements]:
 
Ability to enter and access information from a computer
Occasionally lifts supplies/equipment
Prolonged periods of sitting
Manual dexterity 
 
Working Conditions:
Position available onsite (in Marquette, Michigan), fully remote, or hybrid with a remote work option up to three (3) days per week 
Works in office conditions, but occasional travel is required
Exposure to situations requiring exceptional interpersonal skills or high productivity
Occasionally subjected to irregular hours
Subject to many interruptions
 Remote Work Requirements:
Remote candidates must reside in the state of Michigan
For fully remote team members, initial on-site/in-person onboarding and training for a minimum of ten (10) consecutive business days at UPHP’s headquarters in Marquette, Michigan (stipend provided) 
Periodic travel to UPHP’s headquarters for regular training including all staff meetings
Private home office required; computer and phone hardware provided
Personal vehicle required for periodic travel; mileage reimbursement provided at GSA rate
Employment Type: FULL_TIME

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